Management of chronic cough in adults

• Cough is one of the most common causes of presentation to GPs. Chronic cough causes major physical and psychological morbidity. • Chronic cough may be assessed qualitatively and semiquantitatively using cough counters and cough sensitivity testing. • In most cases, chronic cough is caused by asthma, gastro-oesophageal reflux disease (GORD), postnasal drip syndrome or chronic bronchitis. • Appropriate investigation and empirical treatment should control cough in the majority of individuals. If cause-specific treatment fails then a trial of antitussive therapy is indicated to suppress the cough. • If algorithm-directed investigation and treatment of chronic cough is unsuccessful then referral to a cough clinic may be appropriate.