Non-pharmacological treatment for postural orthostatic tachycardia syndrome: a scoping review protocol.

Objective: The objective of the review is to systematically map the literature on non-pharmacological interventions for postural orthostatic tachycardia syndrome to identify and categorize interventions used, and highlight research gaps to guide future studies.

Introduction: Postural orthostatic tachycardia syndrome is characterized by an excessive increase in heart rate upon standing and symptoms of orthostatic intolerance. Non-pharmacological interventions are first-line treatments; however, the breadth, characteristics, and gaps in the current evidence base have not been systematically mapped, making this scoping review necessary to guide future research directions.

Inclusion criteria: Studies on non-drug, non-procedural, and non-invasive interventions for postural orthostatic tachycardia syndrome in both children and adults will be included. Both direct (affecting patients) and indirect (benefiting but not targeting patients) interventions in any setting will be considered. Original research, systematic reviews, meta-analyses, and gray literature will be included.

Methods: A comprehensive search will be conducted across 6 databases (Ovid MEDLINE, Ovid Embase, Cochrane Library, CINAHL, Scopus, and Web of Science) and gray literature platforms. Searches will be limited to articles in English, Afrikaans, French, German, and Korean, with no restriction on publication date. Two reviewers will independently screen titles and abstracts, as well as full text, against the inclusion criteria. Data will be extracted using a standardized tool and presented to highlight key findings and research gaps. The initial data extraction form was developed after scanning the literature and will be iteratively refined as part of protocol development.

Review registration: Open Science Framework https://osf.io/cg365.