Chronic Refractory Cough: Long-Term Outcomes Following Cough Suppression Therapy

Ethan Simmons; Jessica F Kim; Daniel DeChance; Benjamin J Becerra; Brianna Crawley; Priya Krishna; Thomas Murry

doi:10.1016/j.jvoice.2023.11.011

Chronic Refractory Cough: Long-Term Outcomes Following Cough Suppression Therapy

J Voice. 2023 Dec 5:S0892-1997(23)00371-5. doi: 10.1016/j.jvoice.2023.11.011. Online ahead of print.

Authors

Ethan Simmons¹, Jessica F Kim², Daniel DeChance², Benjamin J Becerra³, Brianna Crawley⁴, Priya Krishna⁵, Thomas Murry⁴

Affiliations

¹ School of Medicine, Loma Linda University, Loma Linda, California. Electronic address: esimmons@students.llu.edu.
² School of Medicine, Loma Linda University, Loma Linda, California.
³ Information & Decision Sciences, California State University, San Bernardino, San Bernardino, California.
⁴ Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, California; Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania.
⁵ Department of Otolaryngology-Head and Neck Surgery, Loma Linda University Health, Loma Linda, California.

PMID: 38057227
DOI: 10.1016/j.jvoice.2023.11.011

Abstract

Objective: This study aimed to determine the long-term outcomes of patients with chronic refractory cough (CRC) following treatment for cough suppression therapy (CST). Currently, there is a lack of objective data regarding the long-term outcome of behavioral treatment for CRC.

Methods: From the charts of 106 adult patients diagnosed with CRC, 24 patients were identified as having long-term data at least 3 months post-CST in the form of otolaryngologic examination, Voice Handicap Index-10 (VHI-10), and Cough Severity Index (CSI) scores. Patients underwent otolaryngologic evaluation and completed the VHI-10 and CSI assessments during pretreatment, posttreatment, and long-term follow-up visits. Patients were also divided into two groups based on their number of comorbidities.

Results: Twenty of the 24 patients had significant reduction in cough severity after completing CST (P < 0.001). A significant difference was also found in CSI scores from pretherapy to the long-term follow-up visits (P = 0.001). No significant difference was found in CSI scores from posttherapy to long-term follow-up visits (P = 0.93). No significant difference was found in VHI-10 scores over time (P = 0.83). No correlation was found between changes in cough and voice severity and number of comorbidities at the tested level.

Conclusions: Findings of no significant change in CRC over the long term compared to posttherapy measures suggest that patients were able to maintain improvement in cough over the long term despite various comorbidities. The current results suggest that CST represents a satisfactory approach to treating CRC and provides patients with an ongoing tool to maintain reduced cough severity. No significant correlations between number of comorbidities and mean CSI or VHI-10 scores were found over the long term.

Keywords: Chronic cough; Chronic refractory cough; Cough severity; Cough suppression therapy; Long-term outcomes.