CHEST 2025: Improving Access to Chronic Cough Treatment Through a Digital Therapeutic Solution

At CHEST 2025, held in Chicago, Illinois, Laurie Slovarp, PhD, CCC-SLP, professor at the University of Montana and certified speech pathologist, discussed the development of a digital therapeutic designed to improve access to behavioral cough suppression therapy (BCST) for patients with refractory chronic cough.

The app incorporates key elements of BCST to educate patients about cough hypersensitivity and provide strategies to reduce cough frequency. Slovarp noted that early findings showed approximately a 40% reduction in cough frequency and significant improvements in quality of life, supporting the potential of this digital tool to expand access to effective care. The study was sponsored by Hyfe, Inc, the developers of the CoughPro and Cough Management applications, and Slovarp serves as a scientific consultant for the company. She also highlighted ongoing collaboration with Kyorin Pharmaceuticals to develop a BCST digital therapeutic for patients in Japan.

Pharmacy Times: Can you introduce yourself?

Laurie Slovarp, PhD, CCC-SLP: I am Dr. Laurie Slovarp. I am a professor at the University of Montana. I am a certified speech-language pathologist, and my research is in the realm of refractory chronic cough.

Pharmacy Times: What inspired the development of this digital therapeutic for chronic cough?

Slovarp: I’ve been treating patients with this condition for many years, and the treatment that we provide works really, really well. In the realm of very few treatments that actually work well, the problem is that there are very few properly trained speech-language pathologists to provide this therapy. So, there is a huge accessibility problem. And that is what led me to try to develop a treatment that would improve accessibility to an efficacious treatment for this population.

Pharmacy Times: How does the virtual behavioral cough suppression therapy (BCST) work to reduce cough frequency?

Slovarp: Refractory chronic cough, which is a very prevalent condition, generally impacts patients for years and years because they are going to multiple physicians to try to find an answer. What we know now is that these patients primarily have a condition that is sometimes called cough hypersensitivity syndrome, and that hypersensitivity can be in the peripheral nerves of the airway or in multiple different areas of the brain.

What’s tricky about finding a treatment for this condition is that it’s multifactorial. Most drugs are designed to target a single mechanism, which works really well for most diseases. That’s not always the case for refractory chronic cough, but behavioral treatment inherently targets multiple mechanisms.

What we’re trying to do with behavioral cough suppression therapy is to basically retrain the nervous system—primarily the central areas of the brain—to stop being overly sensitive so that things that should not be triggering a cough no longer trigger one. By suppressing the cough over time when an urge to cough is felt, we find that patients are not being triggered as often, which indicates that their cough sensitivity is actually changing, addressing the root cause of the cough.

Pharmacy Times: What were the key findings from your team’s evaluation of this tool?

Slovarp: What we did is we put some elements of behavioral cough suppression therapy into an app as a wellness app. It was designed to educate patients about what cough hypersensitivity syndrome is and to give them a few strategies to help them manage their cough.

We gave them three suppression techniques that they could implement when they felt an urge to cough to help minimize cough severity. We measured their cough frequency before treatment for seven days using the CoughPro application on a watch that monitors cough frequency, and then we monitored their cough frequency throughout the entire study.

The outcome was based on an average of cough frequency at weeks three and four—a long period of monitoring their cough. What we found is that patients who went through the study had approximately a 40% reduction in cough frequency, which is pretty remarkable.

We also measured quality of life with a tool called the Leicester Cough Questionnaire, which includes 19 questions. We want that score to go up, and a clinically meaningful improvement in that measure is two points. Eight out of ten of our subjects had an improvement of over two points. So, it provided really strong proof of concept that we can design behavioral cough suppression therapy as a digital therapeutic, which would drastically improve accessibility.

Pharmacy Times: How could this technology help address the limited access to certified BCST providers in the U.S.?

Slovarp: Well, it wouldn’t necessarily improve access to certified providers—we actually don’t have a certification program to provide this therapy—but you do need to be trained. The digital therapeutic would actually replace the speech therapist in some cases.

There are certainly patients who have a voice problem or an upper airway condition associated with this condition; those patients still need to see a trained speech pathologist. But for a large percentage of patients who just have cough hypersensitivity, they would be able to access this technology through an app.

It would explain their condition and what they need to do to help themselves change so that their brain could change and they would no longer be hypersensitive. Because it would be available as an app, everyone would have access to it, and it would absolutely be a massive game changer for improving care for patients with refractory chronic cough.