Management of tinnitus in English NHS audiology departments: an evaluation of current practice

Hoare, Derek J.; Gander, Phillip E.; Collins, Luke; Smith, Stephen L.; Hall, Deborah A.

doi:10.1111/j.1365-2753.2010.01566.x

Cited by 101 publications

(152 citation statements)

References 34 publications

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“…Although many adults experience tinnitus-related distress suffi cient to severely aff ect their quality of life, 3 availability of appropriate specialist psychological support varies geographically both within and between countries. 34,50 …”

Section: Variations In Clinical Practicementioning

confidence: 99%

“…Important questions about tinnitus consequences include its eff ect on sleep and concentration. Several health questionnaires are available that assess the eff ects of tinnitus, of which the tinnitus handicap inventory 33 is the most commonly used in the UK, 34 although the tinnitus functional index 35 might replace it. Questionnaires to assess associated symptoms such as hyperacusis 36 and psychological distress 37 can also be helpful.…”

Section: Investigation and Diagnosismentioning

confidence: 99%

“…34,90 Therefore, although the epidemiology of tinnitus is broadly comparable across countries, international clinical practices diff er (fi gure). For acute subjective tinnitus, pharmacological prescriptions are common, whereas for chronic subjective tinnitus, audiological and psychological approaches are more typical.…”

Section: Variations In Clinical Practicementioning

confidence: 99%

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Tinnitus

Baguley¹,

McFerran²,

Hall³

2013

The Lancet

1,061

911

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Tinnitus is a common medical symptom that can be debilitating. Risk factors include hearing loss, ototoxic medication, head injury, and depression. At presentation, the possibilities of otological disease, anxiety, and depression should be considered. No eff ective drug treatments are available, although much research is underway into mechanisms and possible treatments. Surgical intervention for any otological pathology associated with tinnitus might be eff ective for that condition, but the tinnitus can persist. Available treatments include hearing aids when hearing loss is identifi ed (even mild or unilateral), wide-band sound therapy, and counselling. Cognitive behavioural therapy (CBT) is indicated for some patients, but availability of tinnitus-specifi c CBT in the UK is poor. The evidence base is strongest for a combination of sound therapy and CBT-based counselling, although clinical trials are constrained by the heterogeneity of patients with tinnitus.

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Section: Variations In Clinical Practicementioning

confidence: 99%

Section: Investigation and Diagnosismentioning

confidence: 99%

See 1 more Smart Citation

Tinnitus

Baguley¹,

McFerran²,

Hall³

2013

The Lancet

1,061

911

View full text Add to dashboard Cite

show abstract

“…In the absence of any effective treatment, chronic tinnitus is currently managed clinically by attempting to reduce the percept (with sound therapy) and/or reduce the negative emotional reaction to the percept (using education, counselling, or cognitive behaviour therapy). In the United Kingdom (UK) this clinical management is largely delivered by audiologists, hearing therapists and, occasionally, clinical psychologists [7]. However, the organisation and availability of these services is variable and in a state of flux.…”

Section: Introductionmentioning

confidence: 99%

Equity and person-centeredness in provision of tinnitus services in UK National Health Service audiology departments

Hoare

Broomhead

Stockdale

et al. 2015

EJPCH

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Rationale, aim and objective: Chronic tinnitus is a prevalent condition broadly managed using individualised sound-based interventions, individualised or group education, counselling, or cognitive therapies. In the UK, therapy is largely delivered by audiologists or hearing therapists and, where available, clinical psychologists and physicians. Changes in the structure of the health service necessitate ongoing evaluation to monitor equity and person-centeredness of care. The purpose of the current evaluation was to describe provision and explore diversities in the services provided for tinnitus patients across the four countries of the UK and consider these relative to current commissioning and clinical practice guidelines. Method: A 37 item questionnaire was devised and distributed via email and social media to reach audiology departments in the UK and 147 valid responses were acquired during the 3 month period of the evaluation. Results: The structure and provision of tinnitus services varies widely across the four countries of the United Kingdom in terms of which clinicians provide the services. Outside of England there was no report of clinical psychology or audiovestibular physician involvement in services. There is also variability in access to psychological therapy or support (little training in CBT in Scotland and none in Northern Ireland), self-help groups (little involvement but interest from clinicians) and devices (e.g., one quarter of departments do not currently offer combination hearing aid devices for tinnitus). Clinicians are increasingly using validated questionnaires to evaluate the effectiveness of tinnitus management in their departments. Conclusions: Training in and the provision of psychological support for tinnitus patients by audiologists is particularly a concern for Scotland and Northern Ireland and has implications for the person-centeredness of audiology services. Capacity and need for research in paediatric tinnitus, combination devices, non-ear level sound devices and audiologist-delivered psychological therapy, are noted.

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“…They focus mainly on reduction of tinnitus percept with sound therapy, and/or reduction of negative emotional reaction to tinnitus with cognitive behavior therapy (CBT) or counselling. Currently, access to psychological therapies is reserved for those with the greatest need [5][6][7].…”

Section: Introduction Backgroundmentioning

confidence: 99%