Cough boffins flag treatment changes

What’s the mostly likely reason you’ll head off to see your local GP? The aches and pains that seem to occur more frequently and last longer with each passing year? A heavy cold or flu? Or maybe just the need to renew a prescription for ongoing medication?

As common as those reasons might be, there’s one single symptom that tops all in terms of instigating medical consultation. It’s the humble cough.

The thing about a cough is that it could be an indicator of many things. Some are literally harmless. Who among as hasn’t had to cough as a result of a sharp corn flake lodged in the throat?

And then, of course, there are other relatively innocuous causes – a dry throat for example. Even a ‘bog standard’ cold can induce coughs for a week or two without any serious implications.

But a cough can be an indicator that something more serious is at play. And chronic cough results in significant healthcare costs and can impair quality of life. This can be true even if no serious underlying condition has been identified.

The prevalence of a cough and the fact that it’s the primary reason for medical consultations has brought out the academics. Those academics have combined to publish a paper, one that delivers a new set of recommendations regarding cough.

The paper’s authors, 24 in all, hail from universities and other tertiary institutions across Australia and include several professional health experts.

So what can these academics and experts tell us about cough?

The paper calls for a closer focus on patient history when it comes to chronic cough. This focused approach will help health experts “to identify any red flag cough pointers that may indicate an underlying disease”.

Further, the paper recommends that further assessment of patients older than six should include a chest X‐ray and spirometry. (The commonest type of pulmonary function or breathing test. spirometry measures how much air you can breathe in and out. It also records as how easily and fast you can the blow the air out of your lungs.)

In addition, the statement calls for specific disease guidelines in management of any underlying conditions. The recommendations also call for First Nations adults and children should be considered a high risk group.

One interest aspect of the recommendations is the use of separate diagnostic management algorithms for children and adults.

The underlying message

All recommendations in this paper form what is called position statement summary. It crystallises the main aspects of the full statement from the Thoracic Society of Australia and New Zealand and Lung Foundation Australia for managing chronic cough.

The two organisations have flagged the following changes in management as a result of that statement:

  • Algorithms for assessment and diagnosis of adult and paediatric chronic cough are recommended.
  • High quality evidence supports the use of child‐specific chronic cough management algorithms to improve clinical outcomes, but none exist in adults.
  • Red flags that indicate serious underlying conditions requiring investigation or referral should be identified.
  • Early and effective treatment of chronic wet/productive cough in children is critical.
  • Culturally specific strategies for facilitating the management of chronic cough in First Nations populations should be adopted.
  • If the chronic cough does not resolve or is unexplained, the patient should be referred to a respiratory specialist or cough clinic.

Do we as patients need to do anything differently?

Essentially, no. If these recommendations are adopted and successful, the upshot will hopefully mean you will cough less and breathe easier!

Have you had chronic cough issues? Did you seek medical advice? Was that advice and subsequent treatment (if any) adequate? Let us know via the comments section below.

Also read: Zinc can help reduce the length of respiratory infections: study

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