Chronic coughs are very difficult to treat and impact severely on patients' lives. Not only are they a daily nuisance, but they contribute heavily to social isolation. Patients no longer dare to go to the theatre or cinema, to church or even to impotant meetings.

But Alyn Morice and colleagues at Castle Hill Hospital in Cottingham (UK) have developed a ground-breaking interactive online cough clinic, which gathers information from the patient using a detailed three-page questionnaire. The patient's answers are sent to a server that uses a weighted algorithm developed by experts to assess the most plausible diagnosis among the three commonest causes, namely gastrooesophageal reflux, asthma and rhinitis.

The patient is then sent a personal email that can be shown to the doctor informing him or her of the likely reason for the cough and details of the appropriate treatment under the ERS Guidelines. This procedure allows the doctor to save a considerable amount of time, without in any way undermining his or her expertise.

More than 8,000 participants have already used the service of whom 94% found the website easy to use, and 73% found the advice helpful. Importantly, 60% of patients felt it had helped them to communicate with their GP. And 62% followed the recommended treatment.
www.coughclinic.org.uk

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First Published in November 2008

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