Feasibility and clinical utility of ambulatory cough monitoring in an outpatient clinical setting: a real world retrospective evaluation

Research question Objective quantification of cough is rarely utilised outside of research settings and the role of cough frequency monitoring in clinical practice has not been established. This study examined the clinical utility of cough frequency monitoring in an outpatient clinical setting.

Methods The study involved a retrospective review of cough monitor data. Participants included 174 patients referred for treatment of cough and upper airway symptoms (103 chronic cough; 50 inducible laryngeal obstruction; 21 severe asthma), and 15 controls. Measures, taken prior to treatment, included 24-h ambulatory cough frequency using the Leicester Cough Monitor, the Leicester Cough Questionnaire and Laryngeal Hypersensitivity Questionnaire. Post-treatment data was available for 50 participants. Feasibility and clinical utility were also reported.

Results Analysis time per recording was up to 10 min. Seventy five percent of participants could use the monitors correctly and most (93%) recordings were interpretable. The geometric mean cough frequency in patients was 10.1 (sd=2.9) compared to 2.4 (2.0) for healthy controls, (p=0.003). There was no significant difference in cough frequency between clinical groups, (p=0.080). Cough frequency decreased significantly following treatment, (p<0.001). There was a moderate correlation between cough frequency and both cough quality of life and laryngeal hypersensitivity. Cough frequency monitoring was responsive to therapy, and able to discriminate differences in cough frequency between diseases.

Conclusion While ambulatory cough frequency monitoring remains a research tool, it provides useful clinical data that can assist in patient management. Logistical issues may preclude use in some clinical settings and additional time needs to be allocated to the process.