Internet-Based Behavioral Cough Suppression Therapy for Refractory Chronic Cough: A Randomized Controlled Trial

Purpose: The purpose of this study was to assess the efficacy of internet-based behavioral cough suppression therapy (IBCST) and explore users’ experiences. Method: This study involved a prospective, single-blind, randomized controlled trial comparing the efficacy of a 5-week IBCST and healthy lifestyle education con trol intervention in patients with refractory chronic cough. Additionally, qualitative interviews were conducted and analyzed using grounded theory methodology. Interventions: IBCST and the healthy lifestyle control included 5 weeks of asyn chronous content delivered via video and text on a study-specific website. IBCST emphasized education and cough suppression. Outcomes: The Leicester Cough Questionnaire (LCQ) and Cough Severity Visual Analog Scale (VAS) were the primary and secondary outcome measures, respectively, and were administered at baseline (T0), 1-week posttreatment (T1), and 1-month posttreatment (T2). Semistructured qualitative interviews were con ducted with a subgroup of IBCST participants. Results: Thirty-nine adults with refractory chronic cough enrolled, and 30 (27 women, three men; M_age = 61 years) completed the study (18 IBCST, 12 con trol). IBCST resulted in clinically significant improvements for 72% of partici pants in LCQ total score at T1 with a mean change of 3.74 (p = .014, ηp 2 = .205) and 76% of participants at T2 with a mean change of 4.1 (p = .033, ηp 2 = .163). VAS changes did not reach the minimum clinically meaningful threshold but trended in that direction for the IBCST group at T1 (p = .056, η_p² = .128). Qualitative analysis revealed IBCST participants liked the convenience and qual ity of treatment and experienced improvements in symptom control.