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.
Gastroenterology and Digestive Pathophysiology, Villalba Hospital, Bologna, Italy.
Aging Clin Exp Res. 2022 Jul;34(7):1529-1550. doi: 10.1007/s40520-022-02154-4. Epub 2022 Jun 6.
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.
To develop evidence-based recommendations for the management of adults with CC.
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.
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.
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.
慢性咳嗽(CC)是成人和老年人的一个负担性健康问题,对生活质量有重大影响。其管理通常很麻烦,已经发布了许多指南。尽管如此,仍有一部分病例仍未明确诊断和确定治疗方案。强烈建议不同专业人员之间采取协调的方法,但在临床实践中,由于缺乏共同的方案和对该问题认识不足,其实施受到阻碍。本共识文件的实施就是为了解决这些问题。
为成人 CC 的管理制定基于证据的建议。
成立了一个由全科医生、老年病学家、肺科医生、过敏学家、耳鼻喉科医生和胃肠病学家组成的 12 人专家工作组,制定 CC 患者的诊断和治疗方法的循证建议。采用改良 Delphi 方法达成共识,并使用美国预防服务工作组系统来评估建议的强度和证据质量。
共提出了 56 条建议,涵盖了 28 个主题,涉及定义和流行病学、发病机制和病因、诊断和治疗方法以及特定护理环境的考虑。
这些建议通过协调不同专业人员的专业知识,应该可以简化 CC 患者的管理。通过提供感兴趣的主题列表,可以帮助确定未满足的需求和研究重点。