A RETROSPECTIVE SURVEY OF DIAGNOSIS AND MANAGEMENT OF PATIENTS PRESENTING WITH CHRONIC COUGH TO A GENERAL CHEST CLINIC

Respiratory physicians often encounter patients with chronic cough. Th e evaluation and outcome of such patients by centres with established diagnostic protocols has been well described. By contrast, little is k nown about patients referred to general respiratory clinics where no s uch protocol exists. We describe the findings of a retrospective surve y of all new patient referrals with chronic cough to a general respira tory clinic over a 12-month period. A diagnosis of asthma or chronic a irflow obstruction was made in 43% of patients. Gastro-oesophageal ref lux and postnasal drip syndrome, together accounting for over 60% of d iagnoses in specialist clinics, were infrequently identified in our st udy (4% and 2% respectively). At follow-up, 43% of patients reported p ersistent symptoms, contrasting the excellent treatment response repor ted by specialist clinics. In general respiratory clinics where a spec ific diagnostic protocol is not in place, these differences in diagnos is and outcome may be due to inadequate investigation or may reflect a different patient population.