TY - JOUR T1 - Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction JF - BMJ Open Respiratory Research JO - BMJ Open Resp Res DO - 10.1136/bmjresp-2022-001199 VL - 9 IS - 1 SP - e001199 AU - Jemma Haines AU - Jacklyn Ann Smith AU - James Wingfield-Digby AU - Jenny King AU - Janelle Yorke AU - Stephen J Fowler Y1 - 2022/06/01 UR - http://bmjopenrespres.bmj.com/content/9/1/e001199.abstract N2 - 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.No data are available. No new data sets generated. Data analysis sets of review available upon reasonable request. ER -