Professor and Chair Geisinger Health System and Geisinger Commonwealth School of Medicine Danville, PA, United States
Disclosure(s):
Kenneth W. Altman, MD PhD: No relevant relationships to disclose.
PROGRAM DESCRIPTION: Chronic cough is exceptionally common, accounting for up to 3% of ambulatory clinical visits in the US, and with a prevalence of up to 10% globally. Over the last 20 years evidence-based clinical practice guidelines by the American College of Chest Physicians, the European Respiratory Society and others have matured, but challenges to patient care have remained. The greatest barriers to managing patients with chronic cough have been 1) advancing the science of cough, 2) defining gaps in care delivery of best-practice, and 3) understanding the longitudinal journey of the cough patient as a conduit to comparative effectiveness and outcomes research. The last 5 years have seen significant progress in these areas, to include discovery of the P2X3 ion channel in the cough receptor. It’s preeminent role in cough hyper-excitability is a breakthrough that changes chronic cough as a symptom, to a disease in some patients.
This program presents new discoveries in basic science, population health, and the most current clinical practice guidelines supporting evidence-based state-of-the-art in evaluating and managing chronic cough patients. Since cough may be an indicator of serious underlying disease, a systematic method at evaluation and management is presented, along with appropriate objective testing. Otolaryngologists play a critical role in these patients due to our interdisciplinary approach to the aerodigestive tract, and mastery of many procedures used to evaluate and treat related conditions.
Challenging cases will be presented to demonstrate practical clinical applications. Controversial areas to be discussed include warning signs, decision protocolization, and the introduction of comparative effectiveness for value-based healthcare.
OUTCOME OBJECTIVE 1: 1. Learn the spectrum of common and uncommon causes of chronic cough
OUTCOME OBJECTIVE 2: 2. Understand evidence-based Clinical Practice Guidelines in the evaluation and treatment
OUTCOME OBJECTIVE 3: 3. Explain the latest scientific advances to include cough physiology that may offer new therapeutics
BACKGROUND STATEMENT: Chronic cough is a significant clinical problem commonly seen in otolaryngology. New discoveries and closing the gap in delivering best practice guidelines has changed how we approach these important patients.
