Speech therapy in the management of difficult-to-treat chronic cough - preliminary results.

Marta Dąbrowska,Rafał Krenke,Elżbieta Magdalena Grabczak,Antoni Krzeski,Dorota Rojek,Olga Truba,Aleksandra Rybka,Karolina Klimowicz,Anna Łobacz

doi:10.5603/arm.a2018.0044

Marta Dąbrowska, Rafał Krenke + Show 7 more

Open Access

https://doi.org/10.5603/arm.a2018.0044

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Abstract

The efficacy of management of chronic cough in adults is limited. Speech therapy is one of the few therapeutic methods which seems to be useful in patients with persistent chronic cough. However, the method has not been available in Poland so far. The aim of the study was to implement speech therapy and assess its efficacy in the management of patients with difficult-to-treat chronic cough. Patients, who were diagnosed and managed due to difficult-to-treat chronic cough, were enrolled into the study. Speech therapy was developed on the basis of the technique described by Vertigan. The entire therapy consisted of eight weekly sessions, each lasting 45 minutes. Before and after speech therapy, cough severity and its impact on the quality of life was assessed by the Visual Analogue Scale (VAS) and Leicester Cough Questionnaire (LCQ). Additionally, cough challenge test with capsaicin was performed. Eighteen women were enrolled into the study, 15 of them (83%) attended all treatment sessions (median age 66 years, median duration of cough 60 months). There was a significant decrease in cough severity measured by VAS (46 vs 28 mm, p = 0.016) after completion of speech therapy. A significant improvement in patients' quality of life measured by LCQ (10.7 vs 14.6 points, p = 0.004) and an increase in the threshold of cough reflex measured by capsaicin challenge were also demonstrated. Speech therapy resulted in a decrease in cough severity and improvement of quality of life of females with refractory chronic cough. Our results support the use of speech therapy as add-on treatment in females with difficult-to-treat cough.

Highlights

The efficacy of management of chronic cough in adults is limited
The results of our study demonstrated that speech therapy based on the methods described by Vertigan et al [11, 12, 15] was an effective therapeutic approach for patients with persistent, difficult-to-treat cough
Speech therapy significantly reduced cough severity and improved patients’ quality of life. These results are important in the context of the European Respiratory Society (ERS) and American College of Chest Physicians (ACCP) guidelines which state that the above parameters measure the most important aspects of cough assessment [17, 18]

Summary

Introduction

The efficacy of management of chronic cough in adults is limited. Speech therapy is one of the few therapeutic methods which seems to be useful in patients with persistent chronic cough. The aim of the study was to implement speech therapy and assess its efficacy in the management of patients with difficult-to-treat chronic cough. Material and methods: Patients, who were diagnosed and managed due to difficult-to-treat chronic cough, were enrolled into the study. Chronic cough is a common complaint affecting as many as 10–20% of adult population [1,2,3] It has a negative impact on general health status, including physical, psychological and social domains of quality of life [2]. As smokers still account for a significant proportion of the adult population in Poland (30% of men and 21% of women), smoking related bronchitis is a frequent cause of cough in our country [5].

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