Dataset Information

WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. Updates in COVID-19.

ABSTRACT:

Background

Chronic cough management necessitates a clear integrated care pathway approach. Primary care physicians initially encounter the majority of chronic cough patients, yet their role in proper management can prove challenging due to limited access to advanced diagnostic testing. A multidisciplinary approach involving otolaryngologists and chest physicians, allergists, and gastroenterologists, among others, is central to the optimal diagnosis and treatment of conditions which underly or worsen cough. These include infectious and inflammatory, upper and lower airway pathologies, or gastro-esophageal reflux. Despite the wide armamentarium of ancillary testing conducted in cough multidisciplinary care, such management can improve cough but seldom resolves it completely. This can be due partly to the limited data on the role of tests (eg, spirometry, exhaled nitric oxide), as well as classical pharmacotherapy conducted in multidisciplinary specialties for chronic cough. Other important factors include presence of multiple concomitant cough trigger mechanisms and the central neuronal complexity of chronic cough. Subsequent management conducted by cough specialists aims at control of cough refractory to prior interventions and includes cough-specific behavioral counseling and pharmacotherapy with neuromodulators, among others. Preliminary data on the role of neuromodulators in a proof-of-concept manner are encouraging but lack strong evidence on efficacy and safety.

Objectives

The World Allergy Organization (WAO)/Allergic Rhinitis and its Impact on Asthma (ARIA) Joint Committee on Chronic Cough reviewed the recent literature on management of chronic cough in primary, multidisciplinary, and cough-specialty care. Knowledge gaps in diagnostic testing, classical and neuromodulator pharmacotherapy, in addition to behavioral therapy of chronic cough were also analyzed.

Outcomes

This third part of the WAO/ARIA consensus on chronic cough suggests a management algorithm of chronic cough in an integrated care pathway approach. Insights into the inherent limitations of multidisciplinary cough diagnostic testing, efficacy and safety of currently available antitussive pharmacotherapy, or the recently recognized behavioral therapy, can significantly improve the standards of care in patients with chronic cough.

SUBMITTER: Rouadi PW

PROVIDER: S-EPMC9117692 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. <i>Updates in</i> <i>COVID-19</i>.

Rouadi Philip W PW Idriss Samar A SA Bousquet Jean J Laidlaw Tanya M TM Azar Cecilio R CR Al-Ahmad Mona S MS Yañez Anahi A Al-Nesf Maryam Ali Y MAY Nsouli Talal M TM Bahna Sami L SL Abou-Jaoude Eliane E Zaitoun Fares H FH Hadi Usamah M UM Hellings Peter W PW Scadding Glenis K GK Smith Peter K PK Morais-Almeida Mario M Maximiliano Gómez René R Gonzalez Diaz Sandra N SN Klimek Ludger L Juvelekian Georges S GS Riachy Moussa A MA Canonica Giorgio Walter GW Peden David D Wong Gary W K GWK Sublett James J Bernstein Jonathan A JA Wang Lianglu L Tanno Luciana K LK Chikhladze Manana M Levin Michael M Chang Yoon-Seok YS Martin Bryan L BL Caraballo Luis L Custovic Adnan A Ortego-Martell Jose Antonio JA Lesslar Olivia J Ly OJL Jensen-Jarolim Erika E Ebisawa Motohiro M Fiocchi Alessandro A Ansotegui Ignacio J IJ

The World Allergy Organization journal 20220514 5

<h4>Background</h4>Chronic cough management necessitates a clear integrated care pathway approach. Primary care physicians initially encounter the majority of chronic cough patients, yet their role in proper management can prove challenging due to limited access to advanced diagnostic testing. A multidisciplinary approach involving otolaryngologists and chest physicians, allergists, and gastroenterologists, among others, is central to the optimal diagnosis and treatment of conditions which under ...[more]

PMID: 35600836

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Project description:BackgroundWhile several scoring systems for the severity of anaphylactic reactions have been developed, there is a lack of consensus on definition and categorisation of severity of food allergy disease as a whole.AimTo develop an international consensus on the severity of food allergy (DEfinition of Food Allergy Severity, DEFASE) scoring system, to be used globally.Methods phase 1We conducted a mixed-method systematic review (SR) of 11 databases for published and unpublished literature on severity of food allergy management and set up a panel of international experts.Phase 2Based on our findings in Phase 1, we drafted statements for a two-round modified electronic Delphi (e-Delphi) survey. A purposefully selected multidisciplinary international expert panel on food allergy (n = 60) was identified and sent a structured questionnaire, including a set of statements on different domains of food allergy severity related to symptoms, health-related quality of life, and economic impact. Participants were asked to score their agreement on each statement on a 5-point Likert scale ranging from "strongly agree" to "strongly disagree". Median scores and percentage agreements were calculated. Consensus was defined a priori as being achieved if 70% or more of panel members rated a statement as "strongly agree" to "agree" after the second round. Based on feedback, 2 additional online voting rounds were conducted.ResultsWe received responses from 92% of Delphi panel members in round 1 and 85% in round 2. Consensus was achieved on the overall score and in all of the 5 specific key domains as essential components of the DEFASE score.ConclusionsThe DEFASE score is the first comprehensive grading of food allergy severity that considers not only the severity of a single reaction, but the whole disease spectrum. An international consensus has been achieved regarding a scoring system for food allergy disease. It offers an evaluation grid, which may help to rate the severity of food allergy. Phase 3 will involve validating the scoring system in research settings, and implementing it in clinical practice.

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Dataset Information

WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. Updates in COVID-19.

Background

Objectives

Outcomes

Publications

WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. <i>Updates in</i> <i>COVID-19</i>.

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OmicsDI is part of the ELIXIR infrastructure

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Dataset Information

WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. Updates in COVID-19.

Background

Objectives

Outcomes

Publications

WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. &lt;i&gt;Updates in&lt;/i&gt; &lt;i&gt;COVID-19&lt;/i&gt;.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. <i>Updates in</i> <i>COVID-19</i>.