Non-pharmacological interventions for chronic cough: The past, present and future

Abstract

Non-pharmacological interventions have been explored in people with refractory chronic cough. Normally delivered by Physiotherapists and or Speech and Language Therapists, these interventions aim to educate patients about their cough, provide them with cough suppression techniques and breathing exercises, improve vocal/laryngeal hydration and psychoeducational counselling to help them gain greater control of their cough. Six key studies have been completed over the past 12 years that have consistently found non-pharmacological interventions help to improve quality of life and reduce cough frequency. Some studies also found improvements in cough reflex sensitivity and severity. Despite promising results there now needs to be further work to optimise these interventions. There is a need to standardise terminology used such as relabelling the intervention as cough control therapy and move away from uni-disciplinary terms. Standardised patient selection, including screening protocols, optimal timing and delivery of the interventions as well as the outcome measures used to evaluate interventions need further exploration.

Non-pharmacological Management of Non-productive Chronic Cough in Adults: A Systematic Review

“…PTs and SLPs used similar therapies to treat non-productive chronic cough (i.e., education, laryngeal irritation reduction strategies, cough control, and psychoeducational strategies) ( 21 , 22 , 24 , 26 ). The mechanism of actions of these multicomponent therapies is thought to be driven by a synergistic relationship between the various components to reduce sensory input triggering cough ( 27 ). For example, education provided basic knowledge of cough, which then increased the likelihood of cough control strategies being effective ( 27 ).…”

“…The mechanism of actions of these multicomponent therapies is thought to be driven by a synergistic relationship between the various components to reduce sensory input triggering cough ( 27 ). For example, education provided basic knowledge of cough, which then increased the likelihood of cough control strategies being effective ( 27 ). Comparisons between single and multicomponent therapies could not be made, as time points varied, and no study specifically compared single vs. multicomponent therapies.…”

“…Comparisons between single and multicomponent therapies could not be made, as time points varied, and no study specifically compared single vs. multicomponent therapies. CPAP did improve cough in those with OSA, possibly by its impact on lung inflation or on gastro-esophageal reflux ( 23 , 26 , 27 ), however, its use in other chronic respiratory diseases is unexplored. A recent systematic review explored multimodal treatments for refractory chronic cough and concluded that medical therapy, SLP, and procedural therapy all improve outcomes of chronic cough ( 9 ).…”

Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy

“…Strategies and behavioural guidelines for treatment, as recommended by a speech and language professionals, physiotherapists and respiratory physicians specialising in this area are summarised in Table 13. [118][119][120] Table 12 Treatment of functional globus and dysphagia…”

Effect of Qinbai Qingfei Concentrated Pellets on substance P and neutral endopeptidase of rats with post-infectious cough

“…Cough is a common symptom of respiratory tract infection, which is caused by chemical or mechanical induction of sensory nerve receptors presented in the pharynx, larynx and bronchi [ 1 ]. Based on the duration, cough has been divided into acute cough (< 3 weeks), subacute cough (3–8 weeks) and chronic cough (> 8 weeks) [ 2 ].…”