Chronic cough.
OBJECTIVE
Chronic cough is common and distressing, especially against the background of life-threatening illness. It is a symptom that has received scant attention, often eclipsed by pain, breathlessness, nausea and vomiting.


RESULTS
This paper reviews the recent literature in cough research: its mechanism, assessment and management. There is so little research from supportive and palliative care that much of our knowledge is extrapolated from research elsewhere. Objective measurement of cough has been facilitated by advances in measuring devices, while subjective assessment tools including cough-specific quality of life questionnaires are now available. These are practical, simple to use and can be incorporated into daily practice. A few drugs have come in and out of favour but there has been no solid advance in therapeutic options in over a decade.


CONCLUSIONS
The availability of simple assessment tools places the imperative on clinicians to be more systematic in assessment of cough and its interventions. The mainstay of oral therapy for symptom control remains dextromethorphan, codeine and morphine. The potential for research is huge: from basic scientific understanding to clinical trials of innovative therapies.
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Bee
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Sir Michael Sobell House, Oxford Radcliffe Hospitals NHS Trust and Nuffield Department of Medicine, Medical Sciences Division and Harris Manchester College, Oxford University, Oxford, UK. bee.wee@hmc.ox.ac.uk
D000701:Analgesics, Opioid / Q000627:therapeutic use; D000996:Antitussive Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D003061:Codeine / Q000627:therapeutic use; D003371:Cough / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D003915:Dextromethorphan / Q000627:therapeutic use; D006801:Humans; D009020:Morphine / Q000627:therapeutic use; D010166:Palliative Care; D011795:Surveys and Questionnaires
D000701:Analgesics, Opioid; D000996:Antitussive Agents; D003915:Dextromethorphan; D009020:Morphine; D003061:Codeine