Year of Award

2026

Document Type

Thesis

Degree Name

Speech, Language, and Hearing Sciences

Department or School/College

Speech, Language, Hearing, and Occupational Sciences

Committee Chair

Dr. Laurie Slovarp

Commitee Members

Dr. Jane Reynolds, Dr. Ryan Mizner

Keywords

refractory chronic cough, behavioral cough suppression therapy, closed enrollment group-based intervention, speech-language pathology

Subject Categories

Medical Education

Abstract

Background:

Refractory chronic cough (RCC) is a subtype of chronic cough (CC) that persists

despite guideline-based treatment and can negatively affect quality of life. Behavioral cough

suppression therapy (BCST), typically delivered by speech-language pathologists (SLPs), is an

effective treatment for RCC. However, access to BCST remains limited due to geographic

barriers and a shortage of trained providers. Group-based telehealth may help expand access to

treatment. This study evaluated the effectiveness of BCST delivered via telehealth using

a closed enrollment group model and compared outcomes to a rolling enrollment group model.

Methods:

In this prospective sequential cohort study 32 participants attended one group telehealth session

per week for 4-5 weeks. Each session was led by a trained graduate student or a licensed

SLP. Participants in each group followed the same treatment schedule. Outcomes were measured

using the Leicester Cough Questionnaire (LCQ) and Patient Global Impression of Severity (PGI-

S) at baseline, one-week post-treatment, and one-month post-treatment.

Results:

Participants demonstrated improvement in cough-related quality of life following

treatment. Total LCQ scores improved from baseline to post-treatment by 5.76 points (p

0.0001) and remained relatively unchanged at one-month post-treatment with an LCQ change

score relative to baseline of 5.86. Participants also reported improvement in cough severity on

the PGI-S, with a median reduction of 1.0 (p = 0.003). Compared to the closed enrollment

model, the rolling enrollment model demonstrated slightly greater improvements in both LCQ

and PGI-S outcomes.

vDiscussion:

These findings support the effectiveness of group-based BCST delivered via telehealth in a

closed enrollment model, with participants demonstrating clinically meaningful improvement in

cough-related quality of life. Although both models were effective, slightly greater improvement

was observed in the rolling enrollment model. Group-based telehealth BCST may improve

access to care for individuals with RCC, particularly for those who live in areas without SLPs

trained in BCST.

Key words: refractory chronic cough, behavioral cough suppression therapy, closed enrollment

group-based intervention, speech-language pathology

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© Copyright 2026 Kinsey Louise Roberts