Scaling Chronic Cough Treatment With a Digital Intervention: Laurie Slovarp, PhD

Digitized behavioral cough suppression therapy can offer a safe and highly effective alternative to pharmaceutical standard-of-care for chronic cough, explained Laurie Slovarp, PhD, CCC-SLP, professor in the School of Speech, Language, Hearing, and Occupational Sciences at the University of Montana. While drugs often carry side effect profiles and require indefinite use, the digital therapeutic has no negative side effects and aims to resolve the underlying issue, all while addressing the largest hurdle in care: patient access.

This transcript was lightly edited; captions were auto-generated.

Transcript

How do the efficacy, safety, and scalability of a digitized behavioral intervention like behavioral cough suppression therapy compare with the current pharmaceutical standard of care, and what needs to happen for digital therapeutics to be integrated as a first-line treatment in chronic cough pathways?

As a behavioral therapy, it's extremely safe. There are really no negative side effects to this treatment. It doesn't work for everyone, but it does work for a very large percentage of patients. We find that 70% to 80% of patients who go through this therapy have a clinically relevant improvement, and around 50% have essentially full resolution of their cough, so it's extremely safe.

As far as scalability goes, we just need to continue to build it right now. What we have is just a wellness application, which is more about managing their cough. The full-fledged digital therapeutic would give them all of the information in the full treatment package, as well as the continuous cough frequency monitoring, which would then improve the ability to treat this in a safe treatment without side effects, which is the big game changer from pharmaceuticals.

We know that there are some drugs that are being researched now and some drugs that are already on the market—used as off-label, like neuromodulators—that do help some of these patients, but they have a very large side effect profile, and not every patient tolerates those side effects. The other thing is a lot of those drugs they have to stay on indefinitely to control their cough, whereas behavioral cough suppression therapy is designed to heal your body, essentially, so that the therapy is no longer needed

How does the development of a digital therapeutic specifically address the biggest hurdle in chronic cough care: patient access and standardization of treatment?

A digital therapeutic is on an app, and just about every person in the world nowadays carries a device in their hand, so the accessibility is unheard of, frankly. I mean, even though there's a pharmacy on every corner, people still have to get to the pharmacy, and it's still costly. Obviously, this wouldn't be a free treatment, but as a digital therapeutic that is only used for a certain time period, it would be extremely affordable, not to mention all the money that we would be saving in all of the frequent physician visits and tests that these patients get.

The therapy itself takes effect, typically in 2 to 4 weeks. It's a very short amount of time to try an inexpensive, no-side-effect treatment, and if that treatment doesn't work, then they can go down the pathway of all of the other testing. It would just be really huge for improving accessibility and reducing the cost of care for this very, very prevalent condition.