Chamberlain Mitchell, SA and Garrod, R and Clark, L and Douiri, A and Parker, SM and Ellis, J and Fowler, SJ and Ludlow, S and Hull, JH and Chung, KF and Lee, KK and Bellas, H and Pandyan, A and Birring, SS (2016) Physiotherapy, and speech and language therapy intervention for patients with refractory chronic cough: a multicentre randomised control trial. Thorax. ISSN 1468-3296

[img] Text
PSALTI_manuscript_Thorax_cleanversioncompleted.pdf - Accepted Version
Restricted to Repository staff only until 28 September 2017.

Download (238kB)
[img] Text
Online appendix clean version.pdf - Accepted Version
Restricted to Repository staff only until 28 September 2017.

Download (63kB)
[img] Text
Figure_1_01082016.pdf - Accepted Version
Restricted to Repository staff only until 28 September 2017.

Download (53kB)
[img] Text
Figure 2 28072016 sb.pdf - Accepted Version
Restricted to Repository staff only until 28 September 2017.

Download (52kB)

Abstract

BACKGROUND: Physiotherapy, and speech and language therapy are emerging non-pharmacological treatments for refractory chronic cough. We aimed to investigate the efficacy of a physiotherapy, and speech and language therapy intervention (PSALTI) to improve health-related quality of life (HRQoL) and to reduce cough frequency in patients with refractory chronic cough. METHODS: In this multicentre randomised controlled trial, patients with refractory chronic cough were randomised to four weekly 1:1 sessions of either PSALTI consisting of education, laryngeal hygiene and hydration, cough suppression techniques, breathing exercises and psychoeducational counselling or control intervention consisting of healthy lifestyle advice. We assessed the change in HRQoL at week 4 with the Leicester Cough Questionnaire (LCQ). Secondary efficacy outcomes included 24-hour objective cough frequency (Leicester Cough Monitor) and cough reflex sensitivity. The primary analysis used an analysis of covariance adjusted for baseline measurements with the intention-to-treat population. This study was registered at UK Clinical Research Network (UKCRN ID 10678). FINDINGS: Between December 2011 and April 2014, we randomly assigned 75 participants who underwent baseline assessment (34 PSALTI and 41 controls). In the observed case analysis, HRQoL (LCQ) improved on average by 1.53 (95% CI 0.21 to 2.85) points more in PSALTI group than with control (p=0.024). Cough frequency decreased by 41% (95% CI 36% to 95%) in PSALTI group relative to control (p=0.030). The improvements within the PSALTI group were sustained up to 3 months. There was no significant difference between groups in the concentration of capsaicin causing five or more coughs. INTERPRETATION: Greater improvements in HRQoL and cough frequency were observed with PSALTI intervention. Our findings support the use of PSALTI for patients with refractory chronic cough. TRIAL REGISTRATION NUMBER: UKCRN ID 10678 and ISRCTN 73039760; Results.

Item Type: Article
Additional Information: © The Authors, BMJ Publishing Group; published 28 September 2016 as Chamberlain Mitchell, S.A.F. et al., 2016. Physiotherapy, and speech and language therapy intervention for patients with refractory chronic cough: a multicentre randomised control trial. Thorax, pp.thoraxjnl–2016–208843. Available at: http://dx.doi.org/10.1136/thoraxjnl-2016-208843
Uncontrolled Keywords: Cough, Mechanisms, Pharmacology
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > School of Health and Rehabilitation
Related URLs:
Depositing User: Symplectic
Date Deposited: 20 Oct 2016 11:23
Last Modified: 01 May 2017 10:27
URI: http://eprints.keele.ac.uk/id/eprint/2302

Actions (login required)

View Item View Item