A distinctly integrated care pathway approach was required for managing chronic cough. Most chronic cough patients first saw a primary care physician, but due to restricted access to advanced diagnostic tests, their involvement in optimal management could be difficult. The best way to identify and treat illnesses that caused or worsened cough was through a multidisciplinary approach comprising, among others, gastroenterologists, allergists, otolaryngologists, and chest doctors. These might include upper and lower airway diseases, viral and inflammatory conditions, or gastroesophageal reflux. Despite the extensive arsenal of ancillary tests used in multidisciplinary cough therapy, such management only occasionally eliminates cough. It might be partially attributed to the scant information available regarding the effectiveness of testing (such as spirometry and exhaled nitric oxide) and conventional medicines used in interdisciplinary specialties for chronic cough. Multiple concurrent cough trigger mechanisms and the central neuronal intricacy of chronic cough were 2 additional significant variables. Cough-specific behavioral counseling and medication using neuromodulators were only a few examples of the subsequent management practices used by cough specialists to control coughs that had not responded to earlier interventions. Although preliminary findings on using neuromodulators as a proof-of-concept are promising, there wasn’t much proof of their effectiveness and safety. The most recent research on the therapy of chronic cough in primary, multidisciplinary, and cough-specialty care was examined by the World Allergy Organization (WAO)/Allergic Rhinitis and its Impact on Asthma (ARIA) Joint Committee on Chronic Cough. Researchers also analyzed knowledge gaps in behavioral therapy for chronic cough, classical and neuromodulator medication, and diagnostic testing. The WAO/ARIA consensus on chronic cough’s third section proposed a chronic cough management algorithm in the context of an integrated care pathway strategy. Understanding the inherent limits of multidisciplinary cough diagnostic tests, the effectiveness, and safety of the currently available antitussive medication, or the recently acknowledged behavioral therapy could greatly enhance the standards of care for patients with chronic cough.

Source:www.sciencedirect.com/science/article/pii/S1939455122000254