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

Jemma Haines, Jacklyn Ann Smith, James Wingfield-Digby, Jenny King, Janelle Yorke, Stephen J Fowler

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish
Article numbere001199
JournalBMJ Open Respiratory Research
Volume9
Issue number1
DOIs
Publication statusPublished - 15 Jun 2022

Keywords

  • asthma
  • not applicable

Fingerprint

Dive into the research topics of 'Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction'. Together they form a unique fingerprint.

Cite this