- To determine if a standardised clinical management pathway improves clinical outcomes
- To assess the reliability, validity and direct health costs of this pathway
- To examine the feasibility of using the standardised pathway in a range of settings
- To describe the outcomes of chronic cough in Indigenous children.
- To provide a substantial and achievable advance in the evidence on the management of chronic cough in children
- To contribute to clinical policy and form the basis of updated clinical practice guidelines with specific data relevant to Indigenous children
- To provide pilot data on the feasibility of this approach in the primary care setting
- To support the earlier detection of respiratory problems which are highly prevalent in Indigenous Australians.
Chronic cough is a common presenting symptom to doctors. It is associated with significant morbidity and may be a symptom of a serious underlying problem.
A standardised clinical management pathway has the potential to reduce the morbidity of chronic cough, unnecessary costs and adverse events of medications used, as well as encourage early referral of children with chronic lung disease. By assessing the effect of the clinical pathway in a multicentre study in various specialist clinics, the results should be generalised to other similar settings
Implications for policy and practice:
This study will contribute to clinical policy and improve clinical outcomes and early diagnosis of respiratory illnesses.
Our research has found:
The study involved five major hospitals and three rural-remote clinics. 346 children newly referred with chronic cough were prospectively managed in accordance with an evidence-based cough algorithm.
We found that the high burden of cough is independent of children’s age and the cause of the cough but dependent on the clinical setting. Irrespective of clinical setting and age, children with chronic cough should be carefully evaluated and child-specific evidence-based algorithms used.
- Kobi Schutz
- National Health and Medical Research Council (NHMRC).
- Anne Chang, Menzies School of Health Research and Queensland Children’s Medical Research Institute
- Peter Morris, Menzies School of Health Research
- Colin Robertson, Royal Children’s Hospital, Melbourne
- Peter Van Asperen, The Children’s Hospital at Westmead
- Nicholas Glasgow, Australian National University
Ian Masters, Royal Children’s Hospital, Brisbane.
- Chang, A.B., Robertson, C.F., van Asperen, P.P., Glasgow, N.J., Mellis, C.M., Masters, I.B., et al (2012). A multicentre study on chronic cough in children: burden and etiologies based on a standardized management pathway. Chest, 142, 943-950.