Cough control therapy for fibrotic interstitial lung disease related chronic cough: feasibility study
Interstitial lung disease
This is a feasibility multi-centre study to assess the feasibility of CCT for people with ILD and chronic cough. The study will recruit 50 participants with a diagnosis of fibrotic ILD and chronic cough (cough ≥8 weeks duration) across Manchester Foundation NHS Trust (MFT) and Guy’s and St Thomas’ NHS Foundation Trust (GSTT) over a 9-month period. Participants will be recruited by their clinical care ILD teams at MFT and GSTT which consists of Respiratory Consultants, Respiratory Nurses and Research Respiratory Nurses and provided written information regarding the study. Informed consent will be obtained by the study Research Nurse, midwife or Allied Health professional (NMAHP) at each site. Once consented participants will attend a baseline assessment visit (Visit 1) at their recruiting site (either Guy’s and St Thomas’ or Manchester Foundation Trust). During this visit they will be asked to complete the following questionnaires and patient reported assessments: 1. Leicester Cough Questionnaire (LCQ), a 19 question cough related quality of life questionnaire, Likert scale. 2. King’s Brief ILD Questionnaire (KBILD), a 15 question ILD related quality of life questionnaire, Likert scale. 3. Cough severity Visual Analogue scale (VAS) 4. Generalised Anxiety Disorder Assessment (GAD-7), 7 question questionnaire, Likert scale. 5. Patient Health Questionnaire (PHQ-9), 9 question questionnaire, Likert scale. 6. Dyspnoea-12 (D-12), 12 question breathlessness questionnaire, Likert scale. 7. EuroQoL-5D (EQ-5D), 5 question cost effectiveness questionnaire, Likert scale. The study NMAHP who will not be involved in delivering the cough control therapy but will be available at the baseline visit (V1) to assist the participants with completing these as necessary. One of the study team will also fit participants with a VitaloJAK cough monitor at this visit. The VitaloJak is a digital cough monitor which is an objective digital cough monitor which consists of a portable sound rec
1. Adults (>=18 years old) with a confirmed diagnosis of Fibrotic Interstitial Lung Disease on high resolution CT 3, defined as reticular abnormality with traction bronchiectasis, with or without honeycombing, with symptomatic fibrotic disease) and chronic cough lasting >=8 weeks. 2. Patients with signs or symptoms for co-morbidities associated known to be associated with chronic cough should be treated prior to the inclusion of the study. 3. Participants able to access and use technology required for the virtual sessions. 4. Patients on a stable dose of MST for at least a month and still have a patient reported troublesome cough to warrant treatment.
1. Upper or lower respiratory tract infection in past 2 months. 2. Currently taking or a history of ACE-inhibitor medications in the past 3 months (which can cause chronic cough). 3. Current smokers (cigarettes or e-cigarettes, self-reported). 4. Respiratory disease other than fibrotic interstitial lung disease e.g. COPD or bronchiectasis. 5. Currently or due to participate in pulmonary rehabilitation or receiving Physiotherapy/speech and language therapy for chronic cough or breathing pattern dysfunction in the next four months (as there is cross over of some of the breathing techniques taught in pulmonary rehabilitation and cough control therapy which may affect results). 6. Patients who have started new antifibrotic medication for their ILD <8 weeks duration. 7. Unable to provide informed consent.