P61 A WEB-BASED CLINIC “COUGH CLINIC”

¹H. Fathi, ²P. W. Dettmar, ²V. Strugala, ²H. Dettmar, ¹C. Wright, ¹A. H. Morice. ¹Department of Academic Medicine, University of Hull, Castle Hill Hospital, Cottingham, UK, ²Technostics Ltd, The Deep Business Centre, Hull, UK

Background: Cough is a very common symptom prompting a medical opinion. In the absence of other obvious chest disease, chronic cough is a diagnostic challenge. Online clinics aim to help by providing targeted information in response to specific answers to an online questionnaire. We aimed to make the European Respiratory Society guidelines on the management of cough more practical, while at the same time providing information about the condition for both patients and physicians at the distance of a click!

Methods: On a secure provider, patients were required to complete a questionnaire if over 18 years of age. A normal chest x ray within a year was necessary and history of haemoptysis was an exclusion criterion. An algorithm was applied after assigning weighting factors to the patients symptoms, to give a percentage of the maximum probability of having the three main causes of chronic cough: reflux, asthma or rhinitis. Based on guidelines, the best approach was suggested to the patient in a letter to their GP. The patient was asked to complete a follow-up questionnaire at 2 months to assess the current situation and response.

Results: Up until July 2008, 14 037 patients (58% women, mean age of 45 years) registered with the site. 8884 patients completed the questionnaire. 46.48% were diagnosed with reflux, 38.31% and 15.21% with asthma and rhinitis, respectively. 1066 (12%) completed the follow-up questionnaire out of whom 94% found the site easy to use, 68% took the recommended medication, 73% found it helpful and 60% suggested it helped in having a better communication with …