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Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction
Haines, J. Smith, J. A. Wingfield-Digby, J. King, J. Yorke, Janelle Fowler, S. J.
Haines, J.
Smith, J. A.
Wingfield-Digby, J.
King, J.
Yorke, Janelle
Fowler, S. J.
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Abstract
Introduction: Inducible laryngeal obstruction (ILO) describes transient laryngeal closure during respiration and can cause significant morbidity. Non-pharmacological behavioural therapy is the commonly cited treatment but efficacy is largely unknown.
Aim: To synthesise the current evidence base on the effectiveness of non-pharmacological interventions used to treat adults with ILO.
Methods: Electronic databases (Medline/Embase/CINAHL/PsycINFO/AMED/CENTRAL) were systematically searched, informed by a population, intervention, comparison, outcome framework. Two reviewers independently screened a representative sample, with lead-author completion due to excellent inter-rater reliability. Data was extracted using a predefined piloted form. Methodological quality was appraised (blindly by two reviewers) using the Joanna Briggs Institute Critical Appraisal Tools. A narrative synthesis was performed due to heterogeneity of studies (PROSPERO registration number: CRD42020213187).
Results: Initial searching identified 3359 records. Full-text screening occurred in 92 records and 14 studies, comprising 527 participants, were deemed eligible. All studies were low-level evidence (observational by design, with four case reports), with a high risk of bias; none contained control arms for comparison. Intervention description was inconsistently and poorly described but direction of effect was positive in 76% of outcomes measured. The majority of studies showed a reduction in symptom scores and improved direct laryngeal imaging post intervention; there was an overall reduction, 59.5%, in healthcare utilisation.
Discussion: The literature is in an embryonic state and lacks robust data to truly inform on the effectiveness of non-pharmacological interventions used to treat adults with ILO. However, positive signals in the synthesis performed support non-pharmacological treatment approaches and further development is warranted.
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2022
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Haines J, Smith JA, Wingfield-Digby J, King J, Yorke J, Fowler SJ. Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction. Vol. 9, BMJ Open Respiratory Research. BMJ; 2022. p. e001199.