Objective
Chronic cough (CC) is assessed and treated extensively as per established pharmacological protocols, but it persists or recurs in many individuals. With the understanding of the underlying cough hypersensitivity and neurophysiology, there has been a rise in behavioural interventions for CC. Literature shows better outcomes when managing CC with combined approaches than solely pharmacological approaches. A multidisciplinary behavioural intervention was devised for CC – Comprehensive Cough Therapy Program (CCTP). This module included Western behavioral management practices of CC and traditional yogic breathing practices. This study aimed to investigate the effectiveness of CCTP in individuals with CC along with standard medical care.

Method/Design
A single blinded randomized controlled trial was conducted (Registered number: CTRI/2023/05/052696). Forty participants were randomized into two groups – Medical + Cough (MC) or Medical Only (MO) intervention. MC group (n=18) received standard medical care and CCTP, whereas MO group (n=17) received only standard medical care after group allocation. Data was collected during baseline (in-person) and follow-up after one-month (in-person or online). Primary outcome measures included Leicester Cough Questionnaire (LCQ), Cough Symptom Score, and Cough Visual Analog Scale (CVAS). The secondary outcome measures included acoustic, perceptual, and self-reported parameters of voice. Mann-Whitney U and Wilcoxon Signed Rank tests were used to analyse within- and between-group differences. Effect sizes were calculated using Cohen’s d.

Results
Both groups improved significantly from their respective treatments. However, the magnitude of improvement across all primary outcomes in MC group (p<0.01) was statistically more significant than MO group (p<0.05). The effect size based on primary outcomes ranged between 0.3-0.6 and 0.6-0.7 in MO and MC group respectively. Nearly 89% of participants in the MC group improved on both LCQ and CVAS, whereas only 76% and 65% of participants in the MO group showed improvement on LCQ and CVAS, respectively.

Conclusion
A combination of medical intervention and CCTP can be beneficial in ameliorating CC. The findings from this research may encourage referrals and facilitate quicker access to behavioural intervention provided by speech language pathologists.