Effectiveness of a tinnitus management programme: a 2-year follow-up study

BACKGROUND Tinnitus impairs the possibility of leading a normal life in 0.5-1% of the population. While neither medical nor surgical treatment appears effective, counselling may offer some relief. An intervention combining counselling and hearing devices is offered to clients referred to the Centre for Help Aids and Communication (CHC) in southern Denmark. The aims of this exploratory study were to examine i) the characteristics of CHC's clients and their tinnitus, ii) the effectiveness of the treatment, and iii) whether particular client groups benefit more than others. METHODS One hundred new clients presenting with tinnitus completed the Tinnitus Handicap Inventory (THI) three times - before their first consultation, after one month and after 1-2 years. The scores were tested for significant differences over time using tests for paired data. Logistic regression was used to examine factors associated with a clinically important difference (i.e. THI score improvement of at least 20 points). RESULTS At final follow-up, total THI score was significantly lower than baseline, i.e. 29.8 (CI 25.5-34.2) vs. 37.2 (CI 33.1-37.2), p < 0.01. The programme achieved a clinically important difference for 27% and 24% of the clients one month and 1-2 years after the first consultation, respectively. It appeared that greater improvement in THI score was related to higher baseline THI score and possibly also to treatment by a particular CHC therapist. The absolute reduction in mean THI score after 1-2 years for clients with moderate and severe handicap was 14 and 20 points, respectively, i.e. similar to that previously reported for TRT (14-28 points). The cost of the current programme was approximately 200 EUR per client. CONCLUSION The tinnitus management programme appeared to provide significant benefit to many clients at a relatively low cost. It would be useful to conduct a randomised controlled study comparing the current programme with alternative forms of combination counselling/sound therapy approaches.