Clinical pathways for chronic cough in children

Bailey EJ, Morris PS, Kruske SG, Chang AB

Published Online:

October 7, 2009

Clinical pathways are used for various chronic diseases to facilitate diagnosis; aid decision making; and provide efficient care to patients. Chronic cough in children is a significant medical problem and in some situations, warrants thorough investigation. This review examined whether using clinical pathways for investigating and managing children with chronic cough were effective. No studies were found that used a clinical pathway for chronic cough in children. Therefore there is insufficient data to make recommendations regarding the use of clinical pathways for chronic cough in children.

Abstract (click to read)

Background:

Chronic cough (a cough lasting longer than 4 weeks) is a common symptom presenting to primary care in Australia and internationally. Chronic cough costs the community, is distressing to parents, and ignoring cough may lead to delayed diagnosis and illness progression of serious underlying respiratory disease. Clinical guidelines have been shown to provide more efficient and effective patient care and can clarify clinical decision making. Cough guidelines have been designed to facilitate management of chronic cough, however treatment recommendations vary and specific clinical pathways for the treatment of chronic cough in children are important, as the cause and treatments for cough in a child vary significantly adults. Therefore, it would be beneficial to clinical practice to systematically evaluate the use of clinical pathways for the treatment of chronic cough in children.

Objectives:

To evaluate the effectiveness of using a clinical pathway in the management of children with chronic cough.

Search strategy:

The Cochrane Register of controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE, EMBASE, review articles and reference lists of relevant articles were searched. The search was carried out in June 2009.

Selection criteria:

All randomised controlled trials with parallel group design comparing use vs non-use of a clinical pathway for treatment of chronic cough in children.

Data collection and analysis:

Results of searches were reviewed against the pre-determined criteria for inclusion. Two reviewers independently selected the studies and it was planned that data extraction would have been done in duplicate.

Main results:

The search identified 471 potentially relevant titles but no studies met criteria for inclusion in the review.

Authors' conclusions:

Without further available evidence, recommendations for the use of clinical pathways for the treatment of chronic cough in children cannot be made. Until further evidence is available, the decision for further investigation and treatment for the child presenting with chronic cough should be made on an individual basis (i.e. dependent on symptoms and signs) with consideration for existing data from other Cochrane reviews on specific treatments for cough. Trials are required to provide evidence on the effectiveness of clinical pathways for the treatment of chronic cough in children.

This record should be cited as:

Bailey EJ, Morris PS, Kruske SG, Chang AB. Clinical pathways for chronic cough in children. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD006595. DOI: 10.1002/14651858.CD006595.pub2

Assessed as up to date:

July 10, 2009

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Primary Review Group:

Airways Group

Health topics:

Lungs & airways > Chronic cough

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Clinical pathways for chronic cough in children

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