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Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction

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 t...

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Autores principales: Haines, Jemma, Smith, Jacklyn Ann, Wingfield-Digby, James, King, Jenny, Yorke, Janelle, Fowler, Stephen J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204450/
https://www.ncbi.nlm.nih.gov/pubmed/35705262
http://dx.doi.org/10.1136/bmjresp-2022-001199
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author Haines, Jemma
Smith, Jacklyn Ann
Wingfield-Digby, James
King, Jenny
Yorke, Janelle
Fowler, Stephen J
author_facet Haines, Jemma
Smith, Jacklyn Ann
Wingfield-Digby, James
King, Jenny
Yorke, Janelle
Fowler, Stephen J
author_sort Haines, Jemma
collection PubMed
description 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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spelling pubmed-92044502022-06-29 Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction Haines, Jemma Smith, Jacklyn Ann Wingfield-Digby, James King, Jenny Yorke, Janelle Fowler, Stephen J BMJ Open Respir Res Asthma 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. BMJ Publishing Group 2022-06-15 /pmc/articles/PMC9204450/ /pubmed/35705262 http://dx.doi.org/10.1136/bmjresp-2022-001199 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Asthma
Haines, Jemma
Smith, Jacklyn Ann
Wingfield-Digby, James
King, Jenny
Yorke, Janelle
Fowler, Stephen J
Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction
title Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction
title_full Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction
title_fullStr Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction
title_full_unstemmed Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction
title_short Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction
title_sort systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction
topic Asthma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9204450/
https://www.ncbi.nlm.nih.gov/pubmed/35705262
http://dx.doi.org/10.1136/bmjresp-2022-001199
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