Assessment and Management of Chronic Cough - Research Review - Final | AHRQ Effective Health Care Program

Assessment and Management of Chronic Cough - Research Review - Final | AHRQ Effective Health Care Program

Research Activities, February 2013: Comparative Effectiveness: Some assessment tools and medications are effective for chronic cough

Some assessment tools and medications are effective for chronic cough

A new research review from the Agency for Healthcare Research and Quality (AHRQ) finds that several tools are valid and reliable for evaluating chronic cough severity, frequency, and impact on quality of life. Evidence suggests the Leicester Cough Questionnaire and Cough-specific Quality of Life Questionnaire for adults and the Parent Cough-specific Quality of Life questionnaire for children may be valid instruments. Electronic recording devices, in general, also appear to be valid assessments of cough frequency compared with human cough counts.

Cough is the most common complaint for which patients seek medical attention, accounting for over 26 million office visits annually. Cough that lasts more than 4 weeks in children younger than 14 years of age or more than 8 weeks in adolescents and adults 14 years of age and older is considered to be chronic by the American College of Chest Physicians.

While a wide variety of medicines have been used to treat the symptom of chronic cough, opioid and certain nonopioid/ nonanesthetic antitussives demonstrated the most promise for managing chronic cough in adults. In particular, codeine and dextromethorphan were effective in reducing cough frequency and severity compared with a placebo. However, given limited evidence it is too early to draw strong conclusions about the comparative effectiveness of these medicines. There is a need for further studies in patient populations with unexplained or refractory chronic cough that use more systematic design and reporting and include assessment of the patient-centered outcomes. This is in contrast to the more extensive literature on the management of acute cough.

These findings can be found in the research review Assessment and Management of Chronic Cough that can be found on AHRQ's Effective Health Care Program Web site at http://www.effectivehealthcare.ahrq.gov.