Antonio De Vincentis1, Fabio Baldi2, Massimo Calderazzo3, Umberto Caliceti4, Gabriella Guarnieri5, Francesco Lombardi6, Francesco Paolo Lombardo7, Stefania Maggi8, Graziano Onder9, Adriano Vaghi10, Alessandro Zanasi11, Raffaele Antonelli Incalzi12. 1. Unit of Internal Medicine and Geriatrics, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, 00128, Rome, Italy. a.devincentis@policlinicocampus.it. 2. Gastroenterology and Digestive Pathophysiology, Villalba Hospital, Bologna, Italy. 3. UOC di Pneumologia, Ospedale di Lamezia Terme, ASP di Catanzaro, Italy. 4. Emeritus Professor of Otorhinolaringology, Università di Bologna, Bologna, Italy. 5. Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy. 6. Fondazione Policlinico IRCCS A. Gemelli, and Università Cattolica del Sacro Cuore, Roma, Italia. 7. General Practitioner, Società Italiana di Medicina Generale (SIMG), Pneumology Area, Florence, Italy. 8. Institute of Neuroscience, Aging Branch, CNR, Padua, Italy. 9. Department of Cardiovascular, Endocrine-Metabolic Diseases and Ageing, Istituto Superiore di Sanità, Rome, Italy. 10. ASST-Rhodense, UOC Pneumologia, Garbagnate Milanese, Milan, Italy. 11. Center for Cough Study, Bologna, Italy. 12. Unit of Internal Medicine and Geriatrics, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, 00128, Rome, Italy.
Abstract
BACKGROUND: Chronic cough (CC) is a burdensome health problem in adult and older people, with a major impact on quality of life. Its management is often troublesome, and many guidelines have been released. Notwithstanding, a proportion of cases still do not reach a definite diagnosis and resolutive treatment. A coordinated approach between different specialists would be highly recommended, but its implementation in clinical practice suffers from the lack of shared protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues. AIMS: To develop evidence-based recommendations for the management of adults with CC. METHODS: A 12-member expert task force of general practitioners, geriatricians, pneumologists, allergologists, otorhynolaringologists and gastroenterologists was established to develop evidence-based recommendations for the diagnostic and therapeutic approach to subjects with CC. A modified Delphi approach was used to achieve consensus, and the US Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence. RESULTS: A total of 56 recommendations were proposed, covering 28 topics and concerning definitions and epidemiology, pathogenesis and etiology, diagnostic and therapeutic approach along with the consideration of specific care settings. CONCLUSION: These recommendations should ease the management of subjects with CC by coordinating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities.
BACKGROUND: Chronic cough (CC) is a burdensome health problem in adult and older people, with a major impact on quality of life. Its management is often troublesome, and many guidelines have been released. Notwithstanding, a proportion of cases still do not reach a definite diagnosis and resolutive treatment. A coordinated approach between different specialists would be highly recommended, but its implementation in clinical practice suffers from the lack of shared protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues. AIMS: To develop evidence-based recommendations for the management of adults with CC. METHODS: A 12-member expert task force of general practitioners, geriatricians, pneumologists, allergologists, otorhynolaringologists and gastroenterologists was established to develop evidence-based recommendations for the diagnostic and therapeutic approach to subjects with CC. A modified Delphi approach was used to achieve consensus, and the US Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence. RESULTS: A total of 56 recommendations were proposed, covering 28 topics and concerning definitions and epidemiology, pathogenesis and etiology, diagnostic and therapeutic approach along with the consideration of specific care settings. CONCLUSION: These recommendations should ease the management of subjects with CC by coordinating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities.
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