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Pharmacological and non-pharmacological interventions for cough in adults with respiratory and non-respiratory diseases: A systematic review of the literature

Pharmacological and non-pharmacological interventions for cough in adults with respiratory and non-respiratory diseases: A systematic review of the literature
Pharmacological and non-pharmacological interventions for cough in adults with respiratory and non-respiratory diseases: A systematic review of the literature
The management of cough in adults with respiratory and non-respiratory illnesses is suboptimal and based mostly on clinical opinions rather than evidence. A systematic review was carried out assessing all trials in adult patients with respiratory and non-respiratory diseases (excluding cancer) that had chronic cough as primary or secondary outcome. A total of 1177 trials were retrieved and 75 met the criteria for inclusion in the review. The vast majority were in patients with asthma and chronic obstructive pulmonary disease (COPD). Cough was the primary outcome in less than one-quarter of the studies. The measurement of cough was variable, mostly using unvalidated scales or being part of an overall ‘symptoms’ score. Positive results were overall seen with the use of corticosteroids, leukotriene receptor antagonists, mast cell stabilizers, ipratropium bromide, neltenexine, iodinised glycerol and lidocaine. Speech pathology training and symptom monitoring through SMS messages (accompanied by treatment adjustments) have also shown promise. Evidence for established anti-tussive agents such as codeine was scarce, with positive studies from the 1960s, whilst more recent studies showed no effect in patients with COPD. Many studies had conflicting results. It is imperative that the management of cough and its evidence base be improved, using higher quality research designs and with cough being the primary outcome of trials.

cough, respiratory disease, asthma, copd, bronchitis, systematic review
934-944
Molassiotis, A.
cddf6fdc-a8f5-49cd-bc5b-f9787889e898
Bryan, G.
4e1a340a-be5f-422a-acc3-9bc0090a755b
Caress, A.
46fb4b99-fe08-4603-8749-0b9b7c75d9c1
Bailey, C.
af803055-3a2d-42cf-813c-47558ca0a3e5
Smith, J.
306ead64-2109-42a9-8d5d-56539de3a863
Molassiotis, A.
cddf6fdc-a8f5-49cd-bc5b-f9787889e898
Bryan, G.
4e1a340a-be5f-422a-acc3-9bc0090a755b
Caress, A.
46fb4b99-fe08-4603-8749-0b9b7c75d9c1
Bailey, C.
af803055-3a2d-42cf-813c-47558ca0a3e5
Smith, J.
306ead64-2109-42a9-8d5d-56539de3a863

Molassiotis, A., Bryan, G., Caress, A., Bailey, C. and Smith, J. (2010) Pharmacological and non-pharmacological interventions for cough in adults with respiratory and non-respiratory diseases: A systematic review of the literature. Respiratory Medicine, 104 (7), 934-944. (doi:10.1016/j.rmed.2010.02.010). (PMID:20385478)

Record type: Article

Abstract

The management of cough in adults with respiratory and non-respiratory illnesses is suboptimal and based mostly on clinical opinions rather than evidence. A systematic review was carried out assessing all trials in adult patients with respiratory and non-respiratory diseases (excluding cancer) that had chronic cough as primary or secondary outcome. A total of 1177 trials were retrieved and 75 met the criteria for inclusion in the review. The vast majority were in patients with asthma and chronic obstructive pulmonary disease (COPD). Cough was the primary outcome in less than one-quarter of the studies. The measurement of cough was variable, mostly using unvalidated scales or being part of an overall ‘symptoms’ score. Positive results were overall seen with the use of corticosteroids, leukotriene receptor antagonists, mast cell stabilizers, ipratropium bromide, neltenexine, iodinised glycerol and lidocaine. Speech pathology training and symptom monitoring through SMS messages (accompanied by treatment adjustments) have also shown promise. Evidence for established anti-tussive agents such as codeine was scarce, with positive studies from the 1960s, whilst more recent studies showed no effect in patients with COPD. Many studies had conflicting results. It is imperative that the management of cough and its evidence base be improved, using higher quality research designs and with cough being the primary outcome of trials.

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More information

Published date: July 2010
Keywords: cough, respiratory disease, asthma, copd, bronchitis, systematic review
Organisations: Health Sciences

Identifiers

Local EPrints ID: 168595
URI: http://eprints.soton.ac.uk/id/eprint/168595
PURE UUID: 7d5cc97b-3d10-4739-bb51-03777302eedf
ORCID for C. Bailey: ORCID iD orcid.org/0000-0002-7528-6264

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Date deposited: 01 Dec 2010 09:10
Last modified: 14 Mar 2024 02:18

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Contributors

Author: A. Molassiotis
Author: G. Bryan
Author: A. Caress
Author: C. Bailey ORCID iD
Author: J. Smith

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