title: A systematic review of non-pharmacological interventions for primary Sjögren's syndrome.
abstract: OBJECTIVE
  To evaluate the effects of non-pharmacological interventions for primary SS (pSS) on outcomes falling within the World Health Organization International Classification of Functioning Disability and Health domains.
  
  
  METHODS
  We searched the following databases from inception to September 2014: Cochrane Database of Systematic Reviews; Medline; Embase; PsychINFO; CINAHL; and clinical trials registers. We included randomized controlled trials of any non-pharmacological intervention. Two authors independently reviewed titles and abstracts against the inclusion/exclusion criteria and independently assessed trial quality and extracted data.
  
  
  RESULTS
  A total of 1463 studies were identified, from which 17 full text articles were screened and 5 studies were included in the review; a total of 130 participants were randomized. The included studies investigated the effectiveness of an oral lubricating device for dry mouth, acupuncture for dry mouth, lacrimal punctum plugs for dry eyes and psychodynamic group therapy for coping with symptoms. Overall, the studies were of low quality and at high risk of bias. Although one study showed punctum plugs to improve dry eyes, the sample size was relatively small.
  
  
  CONCLUSIONS
  Further high-quality studies to evaluate non-pharmacological interventions for PSS are needed.
authors.affiliation: Musculoskeletal Research Group, Institute of Cellular Medicine & NIHR Biomedical Research Centre for Ageing and Chronic Diseases, Newcastle University Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne.
authors.forename: Katie L
authors.initials: KL
authors.lastname: Hackett
authors.affiliation: School of Health Sciences, University of East Anglia, Norwich.
authors.forename: Katherine H O
authors.initials: KH
authors.lastname: Deane
authors.affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne Institute of Cellular Medicine & NIHR Biomedical Research Centre for Ageing and Chronic Diseases, Newcastle University.
authors.forename: Victoria
authors.initials: V
authors.lastname: Strassheim
authors.affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne School of Psychology, Northumbria University and.
authors.forename: Vincent
authors.initials: V
authors.lastname: Deary
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Rapley
authors.affiliation: Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne Institute of Cellular Medicine & NIHR Biomedical Research Centre for Ageing and Chronic Diseases, Newcastle University.
authors.forename: Julia L
authors.initials: JL
authors.lastname: Newton
authors.affiliation: Musculoskeletal Research Group, Institute of Cellular Medicine & NIHR Biomedical Research Centre for Ageing and Chronic Diseases, Newcastle University Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne wan-fai.ng@ncl.ac.uk.
authors.forename: Wan-Fai
authors.initials: WF
authors.lastname: Ng
mesh_terms: D015670:Acupuncture Therapy; D004864:Equipment and Supplies; D006801:Humans; D064889:Psychotherapy, Psychodynamic; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012859:Sjogren's Syndrome / Q000628:therapy*; D016896:Treatment Outcome
keywords: Sjogren’s syndrome; dryness; fatigue; function; interventions; non-pharmacological; pain; rheumatology; systematic review