Results from a pilot study suggest that people with tinnitus benefit from a progressive management program including cognitive behavioral therapy (CBT).
James Henry (Veterans Affairs Medical Center, Portland, Oregon, USA) and colleagues assessed the efficacy of an adapted Progressive Tinnitus Management program that involved CBT and education and counseling on how to manage tinnitus, given by telephone rather than in face-to-face consultations.
The researchers included 12 patients with tinnitus alone, 15 with tinnitus plus mild traumatic brain injury (TBI), and nine with tinnitus plus moderate-to-severe TBI. All the patients underwent six telephone intervention sessions from an audiologist and a psychologist over a 6-month period.
The participants completed questionnaires on their symptoms at baseline, and again at 12 and 24 weeks.
All three groups of tinnitus patients had improvements in symptoms following participation in the program. The Tinnitus Handicap Inventory score was reduced in all groups at 24 weeks, compared with baseline, by a mean of 15.8 points in the no TBI group, 7.2 points in the mild TBI group, and 2.3 points in the moderate-to-severe TBI group.
Looking at effect sizes, which show the magnitude of the "real" treatment effect, the team found that they were 1.03, 0.63, and 0.41 in the no, mild, and moderate-to-severe TBI groups, respectively. To put this into perspective, "sizes of 0.20, 0.50, and 0.80 are considered small, medium, and large, respectively," note the authors.
"Adaptation of Progressive Tinnitus Management as a home-based telehealth service has the potential of providing needed tinnitus services to Veterans with and without TBI for a relatively small cost and with minimal effect on individual VA hospitals," write Henry and co-workers in the Journal of Rehabilitation Research and Development.
"The National Offices of Care Coordination and Audiology and Speech Pathology are vested in ensuring that providers consider telehealth options to expand the scope of specialized services that will improve access and to develop, adapt, and disseminate policies, best practices, lessons learned, and successful strategies to improve care."
The researchers acknowledge that the small size of this study makes any definite conclusions impossible, but say that a larger follow-up randomized clinical study is currently underway that they hope will allow them to confirm the efficacy of the program.
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