Statements that achieved consensus

StatementPositive response (8–10), %
1Specialist cough clinics should be established to provide the optimal care for patients with chronic cough and refractory cough.84.9
2Aims of specialist cough clinics should be to improve patient outcomes, optimise investigations and treatment, reduce burden of disease, and advance clinical research through patient registries and interventional clinical trials.94.3
3Specialist cough clinics should be supervised by clinicians with expertise in cough management.96.2
4Specialist cough clinics should provide evaluation and management of chronic cough patients guided by the agreed national and/or international consensus. Such standardised management should also be encouraged in general respiratory, allergy or ENT clinics responsible for the care of patients with chronic cough.90.6
6Cough should be routinely assessed at baseline and follow-up, using a rating scale for cough severity (such as 0–10 score, modified Borg scale, a 0–100 visual analogue scale or an appropriate alternative). Cough-specific quality of life should also be a part of the assessment at specialist cough clinics, particularly for research purposes.73.6
7Cough triggers and cough complications should be a part of routine history taking, preferably by means of validated measurement tools.83.0
8In every patient newly referred with chronic cough, a minimum panel of routine tests should be reviewed, or undertaken if not already performed. The minimum panel of tests are 1) chest X-ray, 2) spirometry (with bronchodilator testing if indicated) and 3) a type 2 inflammatory marker (such as blood eosinophils, fractional exhaled nitric oxide (FENO) or sputum eosinophils).96.2
9Decision to commence opiates (as anti-tussive therapy) should be made by clinicians with expertise in cough management.90.6
10Decision to commence current neuromodulators (such as gabapentin or amitriptyline, as anti-tussive therapy) should be made by clinicians with expertise in cough management.88.7
11Cough control therapy, or speech language and pathology therapy, should be available in specialist cough clinics.90.6
12In specialist cough clinics, multidisciplinary team meetings should take place to discuss complex cough patients.81.1
13Specialist cough clinics should offer opportunities to patients to participate in clinical research or trials of novel cough therapies.94.3
14Specialist cough clinics should participate in local and international audit on an ongoing basis with the aim of providing a high-quality cough service.83.0
15Cough evaluation and management should be integrated into the post-graduate specialty (e.g. respiratory, allergy or ENT) training curriculum.96.2
16Specialty trainees/fellows (e.g. respiratory, allergy or ENT) should be required to undertake a period of training/participate in clinics which regularly receive referrals for chronic cough.92.5

ENT: ear, nose and throat.