RT Journal Article
SR Electronic
T1 Physiotherapy, and speech and language therapy intervention for patients with refractory chronic cough: a multicentre randomised control trial
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 129
OP 136
DO 10.1136/thoraxjnl-2016-208843
VO 72
IS 2
A1 Chamberlain Mitchell, Sarah A F
A1 Garrod, Rachel
A1 Clark, Lynne
A1 Douiri, Abdel
A1 Parker, Sean M
A1 Ellis, Jenny
A1 Fowler, Stephen J
A1 Ludlow, Siobhan
A1 Hull, James H
A1 Chung, Kian Fan
A1 Lee, Kai K
A1 Bellas, H
A1 Pandyan, Anand
A1 Birring, Surinder S
YR 2017
UL http://thorax.bmj.com/content/72/2/129.abstract
AB Background Physiotherapy, and speech and language therapy are emerging non-pharmacological treatments for refractory chronic cough. We aimed to investigate the efficacy of a physiotherapy, and speech and language therapy intervention (PSALTI) to improve health-related quality of life (HRQoL) and to reduce cough frequency in patients with refractory chronic cough.Methods In this multicentre randomised controlled trial, patients with refractory chronic cough were randomised to four weekly 1:1 sessions of either PSALTI consisting of education, laryngeal hygiene and hydration, cough suppression techniques, breathing exercises and psychoeducational counselling or control intervention consisting of healthy lifestyle advice. We assessed the change in HRQoL at week 4 with the Leicester Cough Questionnaire (LCQ). Secondary efficacy outcomes included 24-hour objective cough frequency (Leicester Cough Monitor) and cough reflex sensitivity. The primary analysis used an analysis of covariance adjusted for baseline measurements with the intention-to-treat population. This study was registered at UK Clinical Research Network (UKCRN ID 10678).Findings Between December 2011 and April 2014, we randomly assigned 75 participants who underwent baseline assessment (34 PSALTI and 41 controls). In the observed case analysis, HRQoL (LCQ) improved on average by 1.53 (95% CI 0.21 to 2.85) points more in PSALTI group than with control (p=0.024). Cough frequency decreased by 41% (95% CI 36% to 95%) in PSALTI group relative to control (p=0.030). The improvements within the PSALTI group were sustained up to 3 months. There was no significant difference between groups in the concentration of capsaicin causing five or more coughs.Interpretation Greater improvements in HRQoL and cough frequency were observed with PSALTI intervention. Our findings support the use of PSALTI for patients with refractory chronic cough.Trial registration number UKCRN ID 10678 and ISRCTN 73039760; Results.