Introduction Unexplained chronic cough may persist despite systematic evaluation and medical treatment of relevant comorbidities. Currently there are no effective, acceptable anti-tussive agents for the treatment of such patients and significant physical, social and psychological morbidity is described. The role of non-pharmacological treatment approaches and specifically speech and language therapy have been reported to be effective.
In our specialist tertiary airways service, all patients with unexplained chronic cough greater than 8 weeks in duration, remaining unexplained after investigation and supervised therapeutic trials, are referred for respiratory speech and language therapy (rSLT).
Aims To determine the effect of rSLT on the Leicester Cough Questionnaire (LCQ) and establish specifically whether the impact occurs across each of the described domains: physical, psychological and social.
Methods We included retrospective data from all patients with unexplained chronic cough who completed rSLT between January and June 2016, and who had LCQ data available before and after treatment.
Results Sixteeen full data sets [69% female; median (range) age 58 (35–73) years] were available for analysis; rSLT median = 4, (range = 3–6) sessions. There was overall improvement in LCQ from median (range) 13.0 (7.0–18.0) pre to 17.4 (8.0–21.0) post rSLT [minimal important difference (MID) 1.3; Wilcoxon’s signed rank p < 0.001]. Each domain improved post rSLT: physical from 4.7 (3.0–7.0) pre to 6.0 (2.0–7.0) post (MID 0.2; p = 0.004); psychological: from 4.0 (1.0–6.0) to 6.1 (3.0–7.0) (MID 0.8; p = 0.001); and social from 4.0 (2.0–7.0) to 5.7 (3.0–7.0) post (MID 0.2, p = 0.001). Individual answers to 10 of the 19 LCQ questions showed statistically significant improvements.
Conclusion These preliminary data indicate that rSLT improves cough related symptoms similarly cross all domains. Further investigation is needed to inform which aspects of patients’ cough-related symptoms do/do not improve with therapy to guide treatment refinement. Specifically, closer investigation of response to individual LCQ questions may lead to improvements in therapeutic strategies.