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. The evaluation and outcome of such patients by centres with established diagnostic protocols has been well described. By contrast, little is known about patients referred to general respiratory clinics where no such protocol exists. We describe the findings of a retrospective survey of all new patient referrals with chronic cough to a general respiratory clinic over a 12-month period. A diagnosis of asthma or chronic airflow obstruction was made in 43% of patients. Gastro-oesophageal reflux and postnasal drip syndrome, together accounting for over 60% of diagnoses in specialist clinics, were infrequently identified in our study (4% and 2% respectively). At follow-up, 43% of patients reported persistent symptoms, contrasting the excellent treatment response reported by specialist clinics. In general respiratory clinics where a specific diagnostic protocol is not in place, these differences in diagnosis and outcome may be due to inadequate investigation or may reflect a different patient population.