Evaluation and Management Outcomes and Burdens in Patients with Refractory Chronic Cough Referred for Behavioral Cough Suppression Therapy

Abstract Purpose: The purpose of this study was to investigate the typical symptoms and medical management characteristics of adult patients with refractory chronic cough (RCC) who are referred to speech-language pathology (SLP) for behavioral cough suppression therapy (BCST) in order to estimate cost-effectiveness and efficiency of current practice patterns for this population.Methods: One hundred fifty-nine (159) patients with RCC referred for BCST were surveyed. Patients completed an initial survey at BCST onset related to symptom pattern and prior treatment, including the Leicester Cough Questionnaire (LCQ). Every 4-6 weeks patients completed follow-up surveys to assess their response to BCST.Results: Mean age was 58 years (83% women). The majority of participants reported their cough began two or more years prior to BCST. Approximately half reported seeing four or more physicians (49%) and being prescribed four or more medications (55%) prior to BCST. Medications targeting post-nasal drip (71%), reflux (70%), asthma (56%), and allergies (56%) were most commonly prescribed. BCST resulted in a clinically significant improvement in 113 (70.1%) participants. The mean change in LCQ for those who improved with BCST was 6.61. Over half (58%) reported they were quite satisfied to completely satisfied with their treatment response. The average time from enrollment to study completion was 64 days. Conclusion: The results of this study suggest early intervention with BCST may be a more cost-effective and efficient option for patients with RCC.