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RespiratoryDec 7, 2023

New BTS publication highlights physiotherapists' role in tackling chronic coughing in adults

Physiotherapists are being invited to take part in a free British Thoracic Society (BTS) webinar in February to hear experts discuss a clinical statement  on chronic cough in adults. Physiotherapist Sarah Chamberlain Mitchell was one of the statement's co-authors.

To reserve a place at the event, which is scheduled to take place on 6 February 2024, click  

The BTS has updated its 2006 Guideline on Chronic Cough in Adults in a bid to capture the progress that has since been made in the diagnosis, treatment and management of the condition. It estimates that up to one person in 10 (10 per cent) of people in the UK experience the impacts of chronic cough, with clinicians in both primary and secondary care settings dealing with the issue on a regular basis.

The statement, which was released on the morning of 7 December, highlights the pharmaceutical and non-pharmaceutical measures that should be routinely considered by practitioners and provides practical recommendations on implementing recent evidence. It acknowledges the diverse range of ‘treatable traits’ related to cough, including detail on specific clinical practice points, and the different treatments options.

Photo Credit: Shutterstock
Chronic cough poses a respiratory challenge, involving physios and other clinicians


'Exciting time' for physiotherapy

Dr Chamberlain Mitchell is a senior lecturer in physiotherapy in the faculty of health and education at Manchester Metropolitan University. She said: 'This is an exciting time for physiotherapy as our role with refractory chronic cough has really been highlighted by this clinical statement and endorses the role of a multidisciplinary workforce for the management of these patients.'

Dr Chamberlain Mitchell added: 'This should hopefully lead the way in improving the pathway for these patients to respiratory physiotherapy care and highlight the need for further training of physiotherapists in this area.'

'Pragmatic and personalised approach'

Sean Parker, co-chair of the BTS’s clinical statement group, said: ‘Chronic cough is difficult for patients and clinicians. We hope the statement provides clear practical guidance on the management of cough grounded in routine clinical practice. The treatable traits framework emphasises a pragmatic, personalised approach rather than rigid treatment protocols.'

Dr Parker added: ‘We encourage clinicians to think about how services are delivered and to develop respiratory speech therapy services as an essential part of all respiratory multidisciplinary teams.’

Given that coughing does not usually require specialised procedures and can largely be dealt with in general practice, the statement outlines a high-level workforce framework that can be generally applied across the UK to help to support primary care. Ultimately, the incorporation of speech and language therapists, specialist physiotherapists and nurses should be considered a vital component of delivering effective and cost-effective non-pharmacological cough treatment.

Recognising the role of primary care, the statement endorses a workforce framework to support general practice, highlighting the indispensable contributions of speech and language therapists, specialist nurses, and physiotherapists (Tricia Bryant, PCRS]

Tricia Bryant, executive director of the Primary Care Respiratory Society (PCRS), said: ‘Chronic cough poses a widespread respiratory challenge, involving clinicians across all disciplines. Recognising the role of primary care, the statement endorses a workforce framework to support general practice, highlighting the indispensable contributions of speech and language therapists, specialist nurses, and physiotherapists.

She added: ‘The Primary Care Respiratory Society echoes this sentiment, affirming the significance of this collaborative approach. Essentially, this statement signifies not just progress but sets the groundwork for a future where the management of chronic cough becomes more precise, inclusive, and effective.’

New therapies awaited

Professor Jacky Smith, co-chair of the BTS clinical statement group, said new approaches were in the offing. ‘A number of new therapies are currently in development to address refractory chronic cough, the first of which has recently been licensed in the European Union.

‘We hope this clinical statement lays the groundwork for more efficient evaluation of patients and ultimately access to new effective treatments for those whose cough is refractory to treatment of underlying conditions.’

This article was updated on the evening of 7 December to include comments from Dr Sarah Chamberlain Mitchell.

Author: Edited by Ian A McMillan
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