What are the referral criteria for a patient with chronic cough to a respiratory specialist?

Refer patients with chronic cough to a respiratory specialist if the diagnosis is uncertain, if there has been a failure of empirical treatment, or if the cough is refractory and does not respond to treatment trials ¹.

Specifically, referral is indicated when the cough does not respond to treatment, partially responds (indicating multiple causes), or if the diagnosis remains uncertain ¹.

Additional reasons for referral include suspicion of underlying conditions such as interstitial lung disease, lung cancer, or other significant respiratory pathology, especially if clinical features suggest these diagnoses ¹.

People with clinical features of somatic cough syndrome or tic cough should also be referred for specialist assessment ¹.