Chronic cough is a commonly presented respiratory illness seen by clinicians across both primary and secondary care, with potentially up to 10% of people in the UK experiencing its impacts. Building on the British Thoracic Society (BTS) Guideline on Chronic Cough in Adults that was published in 2006, this new BTS Clinical Statement aims to capture the progress that has since been made in the diagnosis, treatment and management of the condition.
The goal of this Clinical Statement is to bring together both pharmaceutical and non-pharmaceutical measures that should be considered in routine clinical practice across the UK, and to provide practical recommendations as to how clinicians can implement recent evidence when engaging with their adult patients with chronic cough. It acknowledges the diverse range of ‘treatable traits’ related to cough, including detail on specific clinical practice points, and the different treatments options.
Co-chair of the BTS Clinical Statement Group on Chronic Cough in Adults, Dr Sean Parker commented, “Chronic cough is difficult for patients and clinicians. We hope the statement provides clear practical guidance on the management of cough grounded in routine clinical practice. The treatable traits framework emphasises a pragmatic, personalised approach rather than rigid treatment protocols. We encourage clinicians to think about how services are delivered and to develop respiratory speech therapy services as an essential part of all respiratory multi-disciplinary teams (MDT).”
The Clinical Statement also acknowledges the importance of involving the multi-disciplinary respiratory workforce in the treatment and management of cough. Given that cough does not usually require particularly specialised procedures and can largely be dealt with in general practice, the Statement outlines a high-level workforce framework that can be generally applied across the UK to help to support primary care. Ultimately, the incorporation of speech and language therapists, specialist nurses and physiotherapists should be considered a vital component of delivering effective and cost-effective non-pharmacological cough treatment.
On the Statement, Tricia Bryant, Primary Care Respiratory Society (PCRS) Executive Director, said, “Chronic cough poses a widespread respiratory challenge, involving clinicians across all disciplines. Recognising the role of primary care, the Statement endorses a workforce framework to support general practice, highlighting the indispensable contributions of speech and language therapists, specialist nurses, and physiotherapists. The Primary Care Respiratory Society echoes this sentiment, affirming the significance of this collaborative approach. The Clinical Statement not only propels the call for ongoing research but also establishes a platform for enhancing the understanding and management of chronic cough. Essentially, this statement signifies not just progress but sets the groundwork for a future where the management of chronic cough becomes more precise, inclusive, and effective.”
Current evidence in relation to chronic cough is limited, meaning that there is considerable opportunity to continue to advance research in this area. With the addition of this Clinical Statement as one example, BTS aims to continue to support clinicians and patients treating and managing chronic cough.
Co-chair of the BTS Clinical Statement Group on Chronic Cough in Adults, Professor Jacky Smith, further noted, “A number of new therapies are currently in development to address refractory chronic cough, the first of which has recently been licensed in the European Union. We hope this clinical statement lays the groundwork for more efficient evaluation of patients and ultimately access to new effective treatments for those whose cough is refractory to treatment of underlying conditions.”
A webinar, hosted by the BTS, discussing the Clinical Statement on Chronic Cough in Adults will take place on the 6 February 2024. You can learn more about, and register, for the webinar here.
