Telehealth Group Behavioral Cough Suppression Therapy for Refractory Chronic Cough Using a Rolling Enrollment Model

Background Refractory chronic cough (RCC) is a burdensome condition with few effective treatments. While behavioral cough suppression therapy (BCST) has demonstrated high efficacy, access is limited by geographic and provider constraints. This pilot study evaluated the efficacy of BCST delivered in a group telehealth format. Methods BCST was delivered to small groups (2–5 participants) via telehealth using a rolling enrollment model. Participants attended 4–6 sessions (60–90 min each), led by a trained speech-language pathologist and a graduate student. Each session followed a structured format with emphasis on understanding cough hypersensitivity, training in cough suppression techniques, adherence monitoring, and discussion of participant challenges related to cough suppression. Outcome measures included the Leicester Cough Questionnaire (LCQ) and Patient Global Impression of Severity (PGI-S), with optional cough frequency monitoring using the CoughPro smartphone app. Results Forty-seven participants (mean age 56.8; 42 women) from four countries completed the study. Six participants provided sufficient cough monitoring data. Post-treatment, 98% (46/47) exceeded the LCQ's minimal clinically important difference of 1.3 points. Mean LCQ improvement was 7.04 at both one-week and one-month post-treatment assessments (both p<.001, d =2.54 and 2.35, respectively). PGI-S scores showed a median reduction of 2 points. Among those with cough monitoring, mean hourly cough rate dropped by 68%, and cough bouts decreased by 78%. Discussion Group telehealth BCST focused primarily on consistent cough suppression is an extremely efficacious intervention and can increase availability and access to treatment for patients with RCC.