Cough in Children and Adults: Diagnosis, Assessment and Management (CICADA). Summary of an updated position statement on chronic cough in Australia

Julie M. Marchant, Anne B. Chang, Emma Kennedy, David King, Jennifer L. Perret, Andre Schultz, Maree R. Toombs, Lesley Versteegh, Shyamali C. Dharmage, Rebecca Dingle, Naomi Fitzerlakey, Johnson George, Anne Holland, Debbie Rigby, Jennifer Mann, Stuart Mazzone, Mearon OBrien, Kerry Ann O'Grady, Helen L. Petsky, Jonathan PhamSheree M.S. Smith, Danielle F. Wurze, Anne E. Vertigan, Peter Wark

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)
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Abstract

Introduction: Cough is the most common symptom leading to medical consultation. Chronic cough results in significant health care costs, impairs quality of life, and may indicate the presence of a serious underlying condition. Here, we present a summary of an updated position statement on cough management in the clinical consultation. Main recommendations: Assessment of children and adults requires a focused history of chronic cough to identify any red flag cough pointers that may indicate an underlying disease. Further assessment with examination should include a chest x-ray and spirometry (when age > 6 years). Separate paediatric and adult diagnostic management algorithms should be followed. Management of the underlying condition(s) should follow specific disease guidelines, as well as address adverse environmental exposures and patient/carer concerns. First Nations adults and children should be considered a high risk group. The full statement from the Thoracic Society of Australia and New Zealand and Lung Foundation Australia for managing chronic cough is available at https://lungfoundation.com.au/resources/cicada-full-position-statement. Changes in management as a result of this statement: Algorithms for assessment and diagnosis of adult and paediatric chronic cough are recommended. High quality evidence supports the use of child-specific chronic cough management algorithms to improve clinical outcomes, but none exist in adults. Red flags that indicate serious underlying conditions requiring investigation or referral should be identified. Early and effective treatment of chronic wet/productive cough in children is critical. Culturally specific strategies for facilitating the management of chronic cough in First Nations populations should be adopted. If the chronic cough does not resolve or is unexplained, the patient should be referred to a respiratory specialist or cough clinic.

Original languageEnglish
Pages (from-to)35-45
Number of pages11
JournalMedical Journal of Australia
Volume220
Issue number1
Early online date19 Nov 2023
DOIs
Publication statusPublished - 15 Jan 2024

Bibliographical note

Funding Information:
We thank Lung Foundation Australia and the Thoracic Society of Australia and New Zealand for their support in the preparation of these guidelines.

Publisher Copyright:
© 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd.

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