Association of Physicians of India: National Expert Opinion and Clinical Practice Recommendations for Primary Care Cough Management in India

Introduction: Pathological cough in primary care is a significant concern. With a prevalence ranging from 5 to 10% in India, cough is the second most common symptom seen by general practitioners (GPs). The existing algorithms and tools that are available are generally meant for cough categorization in specialized fields; their limited adoption by GPs results in insufficient screening and categorization of cough, which results in the use of irrational fixed drug combination formulations.

Objectives: Formulation of recommendations for GPs to enable them to appropriately screen and categorize cough for efficient management and avoid irrational treatments.

Methods: An expert panel (seven experts specializing in pulmonology and internal medicine) held a virtual discussion to assess the necessity for cough categorization and develop user-friendly tools, along with a simplified format for history taking in cough evaluation and management. Panel discussions were based on a questionnaire that contained items related to the categorization of cough, assessment tools, and approaches to treating cough.

Results: After deliberations, simplified clinical practice recommendations and assessment tools were developed by the experts to facilitate the categorization of cough into wet or dry categories, thereby helping in the symptom-based management of cough.

Conclusion: By adhering to these principles and using assessment tools, primary care practitioners can optimize cough management, avoid irrational drug combinations, minimize potential risks, and improve patient well-being.