CME: Guidance on Treating Unexplained Chronic Cough

CME: Guidance on Treating Unexplained Chronic Cough

Previous studies indicate that unexplained chronic cough—persistent cough with no identifiable cause after investigation and therapeutic trials—occurs in up to 10% of patients seeking medical assistance for chronic cough. “Although cough is just a symptom, it’s a sign of something that can be serious,” says Kenneth W. Altman, MD, PhD, FACS. “Determining the cause can be challenging because an entire spectrum of factors could play a role, ranging from cancer to neurologic causes to smoking.” With the National Ambulatory Medical Survey indicating that 3% of physician office visits in 2005 were for cough and physicians seeing about 1 billion patients each year in the United States, Dr. Altman says the economic impact of cough is significant. “Beyond its high prevalence and burden on the healthcare system,” he says, “the potential seriousness of the disease causing the underlying cough is the most important reason why addressing unexplained chronic cough needs to be better understood and treated.”   A Systematic Review Dr. Altman and a group of experts from the American College of Chest Physicians (ACCP) published a guideline and expert panel report in CHEST on the treatment of unexplained chronic cough. The team first conducted a systematic review of randomized controlled trials among patients older than 12 years with a chronic cough that was unexplained after systematic investigation and treatment and lasted longer than 8 weeks. “We found that the highest-quality trials didn’t have uniform criteria for defining unexplained chronic cough,” says Dr. Altman. “Diagnostic workup, descriptors, and assessments to identify unexplained chronic cough varied among studies. The takeaway message here is that standardization of our approaches to patients with...
Guidance on Treating Unexplained Chronic Cough

Guidance on Treating Unexplained Chronic Cough

Previous studies indicate that unexplained chronic cough—persistent cough with no identifiable cause after investigation and therapeutic trials—occurs in up to 10% of patients seeking medical assistance for chronic cough. “Although cough is just a symptom, it’s a sign of something that can be serious,” says Kenneth W. Altman, MD, PhD, FACS. “Determining the cause can be challenging because an entire spectrum of factors could play a role, ranging from cancer to neurologic causes to smoking.” With the National Ambulatory Medical Survey indicating that 3% of physician office visits in 2005 were for cough and physicians seeing about 1 billion patients each year in the United States, Dr. Altman says the economic impact of cough is significant. “Beyond its high prevalence and burden on the healthcare system,” he says, “the potential seriousness of the disease causing the underlying cough is the most important reason why addressing unexplained chronic cough needs to be better understood and treated.”   A Systematic Review Dr. Altman and a group of experts from the American College of Chest Physicians (ACCP) published a guideline and expert panel report in CHEST on the treatment of unexplained chronic cough. The team first conducted a systematic review of randomized controlled trials among patients older than 12 years with a chronic cough that was unexplained after systematic investigation and treatment and lasted longer than 8 weeks. “We found that the highest-quality trials didn’t have uniform criteria for defining unexplained chronic cough,” says Dr. Altman. “Diagnostic workup, descriptors, and assessments to identify unexplained chronic cough varied among studies. The takeaway message here is that standardization of our approaches to patients with...