https://phaidra.vetmeduni.ac.at/o:1980 WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. Updates inCOVID-19 Rouadi, Philip W. Philip W. Rouadi Eye and Ear University Hospital Beirut / Dar Al Shifa Hospital Ansotegui, Ignacio J. Ignacio J. Ansotegui Hospital Quironsalud Bizkaia Fiocchi, Alessandro Alessandro Fiocchi Bambino Gesù Children's Hospital IRCCS Ebisawa, Motohiro Motohiro Ebisawa Sagamihara National Hospital Jensen-Jarolim, Erika Erika Jensen-Jarolim 0000-0003-4019-5765 University of Veterinary Medicine Vienna / Medical University of Vienna Lesslar, Olivia J. Ly. Olivia J. Ly. Lesslar LifeSpan Medicine Ortego-Martell, Jose Antonio Jose Antonio Ortego-Martell Autonomous University of Hidalgo Custovic, Adnan Adnan Custovic Imperial College London Caraballo, Luis Luis Caraballo University of Cartagena Martin, Bryan L. Bryan L. Martin Ohio State University Chang, Yoon-Seok Yoon-Seok Chang Seoul National University Levin, Michael Michael Levin University of Cape Town Chikhladze, Manana Manana Chikhladze Akaki Tsereteli State University Tanno, Luciana K. Luciana K. Tanno University of Montpellier / WHO Collaborating Centre on Scientific Classification Support Wang, Lianglu Lianglu Wang Bernstein, Jonathan A. Jonathan A. Bernstein University of Cincinnati Sublett, James James Sublett University of Louisville Wong, Gary W. K. Gary W. K. Wong Chinese University of Hong Kong Peden, David David Peden University of North Carolina Canonica, Giorgio Walter Giorgio Walter Canonica Juvelekian, Georges S. Georges S. Juvelekian Hôtel-Dieu de France Klimek, Ludger Ludger Klimek Center for Rhinology and Allergology Gonzalez Diaz, Sandra N. Sandra N. Gonzalez Diaz Universidad Autónoma de Nuevo León Maximiliano Gómez, René René Maximiliano Gómez Catholic University of Salta Morais-Almeida, Mario Mario Morais-Almeida CUF Descobertas Hospital Smith, Peter K Peter K Smith Griffith University Scadding, Glenis K. Glenis K. Scadding RNENT Hospital Hellings, Peter W. Peter W. Hellings KU Leuven / University of Amsterdam / University Hospital Ghent / University Hospitals Leuven Hadi, Usamah M. Usamah M. Hadi American University of Beirut Zaitoun, Fares H. Fares H. Zaitoun LAU-RIZK Medical Center Abou-Jaoude, Eliane Eliane Abou-Jaoude International Cough Institute Bahna, Sami L. Sami L. Bahna Louisiana State University Health Sciences Center Nsouli, Talal M. Talal M. Nsouli International Cough Institute Al-Nesf, Maryam Ali Y Maryam Ali Y Al-Nesf Hamad Medical Corporation Yañez, Anahi Anahi Yañez INAER - Investigaciones en Alergia y Enfermedades Respiratorias Al-Ahmad, Mona S. Mona S. Al-Ahmad Kuwait University Idriss, Samar A. Samar A. Idriss Eye and Ear University Hospital Beirut / Edouard Herriot Hospital Bousquet, Jean Jean Bousquet Humboldt-Universität zu Berlin / Berlin Institute of Health / Université Montpellier Laidlaw, Tanya M. Tanya M. Laidlaw Harvard Medical School Azar, Cecilio R. Cecilio R. Azar American University of Beirut Medical Center / Middle East Institute of Health / Clemenceau Medical Center Elsevier text eng Chronic cough management necessitates a clear integrated care pathway approach. Primary care physicians initially encounter the majority of chronic cough patients, yet their role in proper management can prove challenging due to limited access to advanced diagnostic testing. A multidisciplinary approach involving otolaryngologists and chest physicians, allergists, and gastroenterologists, among others, is central to the optimal diagnosis and treatment of conditions which underly or worsen cough. These include infectious and inflammatory, upper and lower airway pathologies, or gastro-esophageal reflux. Despite the wide armamentarium of ancillary testing conducted in cough multidisciplinary care, such management can improve cough but seldom resolves it completely. This can be due partly to the limited data on the role of tests (eg, spirometry, exhaled nitric oxide), as well as classical pharmacotherapy conducted in multidisciplinary specialties for chronic cough. Other important factors include presence of multiple concomitant cough trigger mechanisms and the central neuronal complexity of chronic cough. Subsequent management conducted by cough specialists aims at control of cough refractory to prior interventions and includes cough-specific behavioral counseling and pharmacotherapy with neuromodulators, among others. Preliminary data on the role of neuromodulators in a proof-of-concept manner are encouraging but lack strong evidence on efficacy and safety.The World Allergy Organization (WAO)/Allergic Rhinitis and its Impact on Asthma (ARIA) Joint Committee on Chronic Cough reviewed the recent literature on management of chronic cough in primary, multidisciplinary, and cough-specialty care. Knowledge gaps in diagnostic testing, classical and neuromodulator pharmacotherapy, in addition to behavioral therapy of chronic cough were also analyzed.This third part of the WAO/ARIA consensus on chronic cough suggests a management algorithm of chronic cough in an integrated care pathway approach. Insights into the inherent limitations of multidisciplinary cough diagnostic testing, efficacy and safety of currently available antitussive pharmacotherapy, or the recently recognized behavioral therapy, can significantly improve the standards of care in patients with chronic cough. Exhaled Nitric-Oxide; Clinical-Practice Guideline; Refractory Chronic Cough; Quality-Of-Life; Mucosal Eosinophilic Inflammation; Gastroesophageal-Reflux Disease; Airway Inflammation; Chest Guideline; Variant Asthma; Inhaled Corticosteroids http://creativecommons.org/licenses/by-nc-nd/4.0/ https://phaidra.vetmeduni.ac.at/api/object/o:1980/download 10.1016/j.waojou.2022.100649 https://phaidra.vetmeduni.ac.at/o:605 application/pdf World Allergy Organization Journal 15(5) (2022) World Allergy Organization Journal 15 5 1.06 MB 2022