o:1980 WAO-ARIA consensus on chronic cough - Part III: Management strategies in primary and cough-specialty care. Updates inCOVID-19 en 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 1552099 10.1016/j.waojou.2022.100649 2023-08-14T08:19:05.627Z 44 yes 46 Philip W. Rouadi Eye and Ear University Hospital Beirut / Dar Al Shifa Hospital Samar A. Idriss Eye and Ear University Hospital Beirut / Edouard Herriot Hospital person Jean Bousquet Humboldt-Universität zu Berlin / Berlin Institute of Health / Université Montpellier person Tanya M. Laidlaw Harvard Medical School person Cecilio R. Azar American University of Beirut Medical Center / Middle East Institute of Health / Clemenceau Medical Center person Mona S. Al-Ahmad Kuwait University person Anahi Yañez INAER - Investigaciones en Alergia y Enfermedades Respiratorias person Maryam Ali Y Al-Nesf Hamad Medical Corporation person Talal M. Nsouli International Cough Institute person Sami L. Bahna Louisiana State University Health Sciences Center person Eliane Abou-Jaoude International Cough Institute person Fares H. Zaitoun LAU-RIZK Medical Center person Usamah M. Hadi American University of Beirut person Peter W. Hellings KU Leuven / University of Amsterdam / University Hospital Ghent / University Hospitals Leuven person Glenis K. Scadding RNENT Hospital person Peter K Smith Griffith University person Mario Morais-Almeida CUF Descobertas Hospital person René Maximiliano Gómez Catholic University of Salta person Sandra N. Gonzalez Diaz Universidad Autónoma de Nuevo León person Ludger Klimek Center for Rhinology and Allergology person Georges S. Juvelekian Hôtel-Dieu de France person Giorgio Walter Canonica person David Peden University of North Carolina person Gary W. K. Wong Chinese University of Hong Kong person James Sublett University of Louisville person Jonathan A. Bernstein University of Cincinnati person Lianglu Wang person Luciana K. Tanno University of Montpellier / WHO Collaborating Centre on Scientific Classification Support person Manana Chikhladze Akaki Tsereteli State University person Michael Levin University of Cape Town person Yoon-Seok Chang Seoul National University person Bryan L. Martin Ohio State University person Luis Caraballo University of Cartagena person Adnan Custovic Imperial College London person Jose Antonio Ortego-Martell Autonomous University of Hidalgo person Olivia J. Ly. Lesslar LifeSpan Medicine person Erika Jensen-Jarolim University of Veterinary Medicine Vienna / Medical University of Vienna person 0000-0003-4019-5765 Motohiro Ebisawa Sagamihara National Hospital person Alessandro Fiocchi Bambino Gesù Children's Hospital IRCCS person Ignacio J. Ansotegui Hospital Quironsalud Bizkaia person person application/pdf 1110133 https://phaidra.vetmeduni.ac.at/o:1980 no yes 18 70 1552253 World Allergy Organization Journal 20 15 5 Elsevier 2022