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Recommendations for the management of cough in adults
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  1. A H Morice1,
  2. L McGarvey2,
  3. I Pavord3,
  4. on behalf of the British Thoracic Society Cough Guideline Group
  1. 1(Chairman), University of Hull, Castle Hill Hospital, Cottingham, UK
  2. 2(Co-Chair), The Queen’s University of Belfast, Belfast, UK
  3. 3(Co-Chair), University Hospitals of Leicester, Glenfield Hospital, Leicester, UK
  1. Correspondence to:
    Professor A H Morice
    University of Hull, Castle Hill Hospital, Cottingham, East Yorkshire HU16 5JQ, UK; a.h.morice{at}hull.ac.uk

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1. INTRODUCTION

1.1 Background

Patients with cough frequently present to clinicians working in both primary and secondary care.1,2 Acute cough, which often follows an upper respiratory tract infection, may be initially disruptive but is usually self-limiting and rarely needs significant medical intervention. Chronic cough is often the key symptom of many important chronic respiratory diseases but may be the sole presenting feature of a number of extrapulmonary conditions, in particular upper airway and gastrointestinal disease. Even with a clear diagnosis, cough can be difficult to control and, for the patient, can be associated with impaired quality of life.3,4 Sessions dedicated to cough at respiratory meetings are popular, suggesting that the pathophysiology, evaluation, and successful treatment of cough remain topics of keen interest to many medical practitioners.

1.2 Need and purpose of BTS recommendations on the management of cough

The American College of Chest Physicians (ACCP) and the European Respiratory Society (ERS)5,6 have each endorsed their own set of guidelines on the management of cough; however, criticism7 of their content and breadth suggest the need for further concise recommendations. The British Thoracic Society guidelines cover not only chronic cough but also acute cough and the organisational issues of cough clinics. International differences in delivery of respiratory health care and management strategies support the notion that such guidelines would be desirable. The British Thoracic Society Standards of Care Committee agreed to the development of a Working Group tasked with the job of producing a set of guidelines for the management of cough with the following key objectives:

  • To produce guidelines that are relevant to the clinical management of cough in both primary and secondary care.

  • To produce a critical review of the available literature.

  • To highlight cough as a clinical and research area of considerable importance.

  • To encourage extended cooperation between clinicians, scientists, and the pharmaceutical industry with the core aim …

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Footnotes

  • Contributors: Professor M Belvisi, National Heart & Lung Institute, London, UK; Dr S S Birring, King’s College Hospital, London, UK; Professor R Eccles, Cardiff University, Cardiff, UK; Professor K F Chung, National Heart & Lung Institute, London, UK; Professor D Geddes, The Royal Brompton Hospital, London, UK; Dr J Haughney, Aberdeen University, Alison Lea Medical Centre, Aberdeen, UK; Dr J A Kastelik, University of Hull, Castle Hill Hospital, Cottingham, UK; Dr J A McGlashan, University of Nottingham, Queen’s Medical Centre, Nottingham, UK; Dr S Packham, Singleton Hospital, Swansea, UK; Dr R Stone, Taunton & Somerset Hospital, Somerset, UK

  • Conflicts of interest: Professor A H Morice has received research monies from Profile Respiratory Systems Ltd, Altana Pharma, AstraZeneca, GlaxoSmithKline (GSK), Schering Plough Research, Novartis; speaker honoraria from AstraZeneca, Altana Pharma, IVAX Pharmaceuticals, GSK, ReckittBenckiser Healthcare, and Novartis; advisory committee honoraria from Proctor and Gamble Healthcare and GSK; and sponsorship to attend international meetings from IVAX Pharmaceuticals and Boehringer Ingelheim. Dr L McGarvey has received speaker honoraria from GSK, AstraZeneca and Boehringer Ingelheim and consultancy honoraria from GSK. Professor I Pavord has received speakers’ fees, research grants and funding to attend international meetings from GSK and AstraZeneca. Professor M Belvisi has received honoraria for consultancy work from GSK; grants from GSK and Novartis; and advisory committee honoraria for Biolipox and Euroscreen. Dr S S Birring has no conflict of interest in relation to this publication. Professor E Eccles has received consultancy fees from Proctor & Gamble and GSK. Professor K F Chung has received speakers’ fees and educational grants from GSK, Novartis, Altana and Boehringer Ingelheim; consultancy honoraria from Scios, GSK, AstraZeneca, Novartis and Pfizer; and research grants from Novartis and GSK. Professor D Geddes has no conflicts of interest. Dr J Haughney has received speaker honoraria from AstraZeneca, Boehringer Ingelheim, Merck Sharp and Dohme, and consultancy honoraria from GSK, Merck Sharp & Dohme, Novartis and Schering Plough. Dr J A Kastelik has received speaker honoraria from AstraZeneca, GSK, Pfizer, Boehringer Ingelheim, Schering Plough and an educational grant from Altana Pharma. Mr J McGlashan discloses research funding, consultancy work and sponsorship to attend international meetings from Reckitt Benckiser, and an educational grant from Laryngograph Ltd. Dr S Packham has received speaker honoraria from AstraZeneca, GSK, and Boehringer Ingelheim and sponsorship to attend scientific meetings from AstraZeneca and GSK. Dr R Stone has received funds for lectures and travel from GSK, Boehringer Ingelheim, and AstraZeneca.

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