What Can Physicians Propose to Help Children with Aspecific Cough? Review of the Literature

Abstract

Aims: New cough guidelines recommend a wait, watch and review attitude without any prescription of medication. However, practitioner adhesion is low. We aimed to search what alternative physician could proposed to drug prescription and what attitude could be effective. Study Design: Review of the litterature. Methodology: The review was performed by two reviewers covering the period from 2008, the date we finished the literature search for our previous guidelines, to March 2015 for guideline, systematic reviews and RCTs. The inclusion criteria were interventions without pharmacological treatment compared with no treatment in coughing children. The target population was the paediatric population between 0 and 18 years old, suffering from cough and not known to be suffering from a specific lung disease. Results: We found three systematic reviews and two primary articles. Interventions used were honey, placebo, GP’s communication skill, and written material given to parents. Outcomes were perception of cough by the parents as assessed by Likert scales, consultation rate and parental literacy. Placebo or honey seemed to be more efficient as regards parents’ perception of their child’s cough. Providing parents with informative, illustrated booklets had an effect on the parents’ knowledge and intention to consult about such symptoms. Conclusion: Our findings support the recommendation of giving information to parents. Placebo seemed to be more efficient than nothing. Its proper use should be specified. There is a need for other studies on which approach works in which circumstances, and when placebo or sugar syrups could be useful.