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Assessment and Management of Chronic Cough [Internet]

Assessment and Management of Chronic Cough [Internet]

Comparative Effectiveness Reviews - Agency for Healthcare Research and Quality (US)

Version: January 2013

Introduction

In the United States, cough is the most common complaint for which patients seek medical attention and is the second most common reason for a general medical examination, accounting for over 26 million office visits annually. Cough often results from an acute, self-limited, viral upper respiratory tract infection; however, there are multiple causes of cough beyond this, including both respiratory tract and nonrespiratory tract-related etiologies. 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 (ACCP)., Such chronic cough is responsible for up to 38 percent of pulmonary outpatient visits., The purpose of this review is to evaluate the effectiveness of instruments to evaluate cough and the comparative effectiveness of treatments for the symptom of cough in patients with either unexplained or refractory chronic cough. Recent studies from the UK, United States, and Japan evaluating patients with chronic cough have estimated that up to 46 percent of patients have idiopathic cough despite a thorough diagnostic investigation.

Methods

The methods for this comparative effectiveness review (CER) follow those suggested in the Agency for Healthcare Research and Quality (AHRQ) Methods Guide for Effectiveness and Comparative Effectiveness Reviews (hereafter referred to as the Methods Guide) and Methods Guide for Medical Test Reviews (hereafter referred to as the Medical Test Guide). The main sections in this chapter reflect the elements of the protocol established for the CER; certain methods map to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. All methods and analyses were determined a priori.

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