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Referral pathway for adults with chronic cough in Switzerland from a Delphi-based consensus study.

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Title: Referral pathway for adults with chronic cough in Switzerland from a Delphi-based consensus study.
Authors: Brutsche, Martin1 (AUTHOR) Martin.Brutsche@kssg.ch, Ballmer-Weber, Barbara2 (AUTHOR), Burri, Emanuel3 (AUTHOR), Clarenbach, Christian4 (AUTHOR), Funke Chambour, Manuela5 (AUTHOR), Leuppi, Jörg D.6 (AUTHOR), Soyka, Michael B.7 (AUTHOR), von Garnier, Christophe8 (AUTHOR), Zeller, Andreas9 (AUTHOR)
Source: Postgraduate Medicine. Apr2026, Vol. 138 Issue 3, p293-308. 16p.
Subject Terms: *Allergies, *Delphi method, Chronic cough, Medical referrals, General practitioners, Pulmonology, Otolaryngologists
Geographic Terms: Switzerland
Abstract: Objectives: The etiology of chronic cough (CC) is varied, making it difficult to manage, particularly when the cough persists despite appropriate treatment of underlying disease (refractory CC) or when no underlying disease or cause can be identified (unexplained CC). There are currently no recommendations in Switzerland outlining how general practitioners (GPs) should approach the management of CC. The aim of this study was to establish a consensus among physicians from various specialties in Switzerland regarding the assessment, treatment, and referral of CC patients. Methods: This Delphi-based consensus study included two survey rounds (May–December 2023) evaluating 71 statements on the assessment of CC and referral pathways among a panel of GPs, pulmonologists, allergologists, gastroenterologists, and ear nose and throat (ENT) specialists with experience managing CC in Switzerland (N = 50). A 9-point scale was used to rate agreement with statements; consensus in agreement or disagreement was achieved when the median of responses fell within 7–9 or 1–3, respectively, less than one third voted outside these ranges, and the interquartile range (IQR) was <4. An interdisciplinary Scientific Committee with representatives from medical disciplines involved in managing CC led the study and provided the context for the referral pathways proposed. Results: Consensus was reached on 84.5% of statements. Agreement was reached on general considerations for CC, initial actions to be taken in primary care, including clinical evaluation, 'red flags' to identify, pathologies to investigate, treatments to consider, and referral route. Two schematics were produced outlining 1) how to perform a basic assessment of CC patients in primary care, and 2) how and when to refer patients to specialists if CC persists. Conclusions: This study provides valuable recommendations for management of CC, promoting standardized assessment and referral of patients, which is not currently achieved in Switzerland. [ABSTRACT FROM AUTHOR]
Copyright of Postgraduate Medicine is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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  Data: Referral pathway for adults with chronic cough in Switzerland from a Delphi-based consensus study.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Brutsche%2C+Martin%22&quot;&gt;Brutsche, Martin&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; Martin.Brutsche@kssg.ch&lt;/i&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ballmer-Weber%2C+Barbara%22&quot;&gt;Ballmer-Weber, Barbara&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Burri%2C+Emanuel%22&quot;&gt;Burri, Emanuel&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Clarenbach%2C+Christian%22&quot;&gt;Clarenbach, Christian&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Funke+Chambour%2C+Manuela%22&quot;&gt;Funke Chambour, Manuela&lt;/searchLink&gt;&lt;relatesTo&gt;5&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Leuppi%2C+J&#246;rg+D%2E%22&quot;&gt;Leuppi, J&#246;rg D.&lt;/searchLink&gt;&lt;relatesTo&gt;6&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Soyka%2C+Michael+B%2E%22&quot;&gt;Soyka, Michael B.&lt;/searchLink&gt;&lt;relatesTo&gt;7&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22von+Garnier%2C+Christophe%22&quot;&gt;von Garnier, Christophe&lt;/searchLink&gt;&lt;relatesTo&gt;8&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zeller%2C+Andreas%22&quot;&gt;Zeller, Andreas&lt;/searchLink&gt;&lt;relatesTo&gt;9&lt;/relatesTo&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Postgraduate+Medicine%22&quot;&gt;Postgraduate Medicine&lt;/searchLink&gt;. Apr2026, Vol. 138 Issue 3, p293-308. 16p.
– Name: Subject
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  Data: *&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Allergies%22&quot;&gt;Allergies&lt;/searchLink&gt;&lt;br /&gt;*&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Delphi+method%22&quot;&gt;Delphi method&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Chronic+cough%22&quot;&gt;Chronic cough&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Medical+referrals%22&quot;&gt;Medical referrals&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22General+practitioners%22&quot;&gt;General practitioners&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Pulmonology%22&quot;&gt;Pulmonology&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Otolaryngologists%22&quot;&gt;Otolaryngologists&lt;/searchLink&gt;
– Name: SubjectGeographic
  Label: Geographic Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Switzerland%22&quot;&gt;Switzerland&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objectives: The etiology of chronic cough (CC) is varied, making it difficult to manage, particularly when the cough persists despite appropriate treatment of underlying disease (refractory CC) or when no underlying disease or cause can be identified (unexplained CC). There are currently no recommendations in Switzerland outlining how general practitioners (GPs) should approach the management of CC. The aim of this study was to establish a consensus among physicians from various specialties in Switzerland regarding the assessment, treatment, and referral of CC patients. Methods: This Delphi-based consensus study included two survey rounds (May–December 2023) evaluating 71 statements on the assessment of CC and referral pathways among a panel of GPs, pulmonologists, allergologists, gastroenterologists, and ear nose and throat (ENT) specialists with experience managing CC in Switzerland (N = 50). A 9-point scale was used to rate agreement with statements; consensus in agreement or disagreement was achieved when the median of responses fell within 7–9 or 1–3, respectively, less than one third voted outside these ranges, and the interquartile range (IQR) was &lt;4. An interdisciplinary Scientific Committee with representatives from medical disciplines involved in managing CC led the study and provided the context for the referral pathways proposed. Results: Consensus was reached on 84.5% of statements. Agreement was reached on general considerations for CC, initial actions to be taken in primary care, including clinical evaluation, &#39;red flags&#39; to identify, pathologies to investigate, treatments to consider, and referral route. Two schematics were produced outlining 1) how to perform a basic assessment of CC patients in primary care, and 2) how and when to refer patients to specialists if CC persists. Conclusions: This study provides valuable recommendations for management of CC, promoting standardized assessment and referral of patients, which is not currently achieved in Switzerland. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Postgraduate Medicine is the property of Taylor &amp; Francis Ltd and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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        Value: 10.1080/00325481.2026.2663615
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        Text: English
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    Subjects:
      – SubjectFull: Allergies
        Type: general
      – SubjectFull: Delphi method
        Type: general
      – SubjectFull: Chronic cough
        Type: general
      – SubjectFull: Medical referrals
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      – SubjectFull: General practitioners
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      – SubjectFull: Pulmonology
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      – SubjectFull: Otolaryngologists
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      – SubjectFull: Switzerland
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              Text: Apr2026
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