Chronic cough: a practical approach for primary care

Chronic cough is defined as a cough persisting for ≥8 weeks and is a common, frequently distressing presentation in UK primary care. Although traditionally understood through an anatomical triad of asthma, reflux and upper airway disease, current British Thoracic Society guidance advocates a multidimensional ‘treatable traits’ framework that recognises cough hypersensitivity as a central mechanism in many patients. Chronic cough is associated with significant physical morbidity, psychological distress, social stigma and increased healthcare use. This article explores the epidemiology and pathophysiology of chronic cough, and outlines a structured approach to clinical history, physical examination, appropriate community-based investigations, and indications for referral to secondary care. It also discusses evidence-informed management strategies in primary care. A structured and person-centred approach can support effective community management while reducing unnecessary investigations and inappropriate prescribing.