The challenge of the ‘unexplained chronic cough’ that just will not go away is a challenge that frustrates many of us. Often patients have seen respiratory, upper GI and eventually they see you as the last resort! Is behavioural therapy the solution we have been missing?
This article presents a single centre review of its algorithm that incorporates behavioural therapy. The results presented report complete resolution of symptoms in 32%, while 53% reported near-complete resolution.
The attraction to this is the non-pharmacological nature of the intervention. The dilemma is the small numbers involved in the study and the authors gracefully point this out in their discussion along with the lack of the use of validated questionnaires. The treatment algorithm presented also allows the decision-making process to be understood. I particularly like the fact that their practice can be implemented or the study repeated to validate the results. I support their conclusions that there may be merit in behavioural modification and that further prospective trials would be helpful. As with all papers the question is: Would I incorporate it into my clinical practice?
