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Smith ME, Sharma D, Rivero-Arias O, Rand K, Barrack L, Ogburn E, Young M, Field P, Multmeier J, Muzaffar J. Digital thErapy For Improved tiNnitus carE Study (DEFINE): Protocol for a randomised controlled trial. PLoS One 2024; 19:e0292562. [PMID: 38180996 PMCID: PMC10769067 DOI: 10.1371/journal.pone.0292562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 09/28/2023] [Indexed: 01/07/2024] Open
Abstract
Tinnitus is a common health condition, affecting approximately 15% of the UK population. The tinnitus treatment with the strongest evidence base is Cognitive Behavioural Therapy (CBT), with standard tinnitus therapy typically augmented with education, relaxation and other techniques. Availability of CBT and conventional tinnitus therapy more broadly is limited for tinnitus sufferers. The DEFINE trial aims to assess whether smartphone-delivered tinnitus therapy, the Oto app, is as effective as current standard care, one-to-one therapist-delivered tinnitus treatment for the treatment of tinnitus in adults. The trial is registered in the ISRCTN Registry: ISRCTN99577932. DEFINE is an open-label, non-inferiority, prospective, parallel design, randomised-controlled trial. Recruitment, interventions and assessments will be remote, enabling UK-wide participant involvement. 198 participants aged 18 years or more will be recruited via social media advertisement or via primary care physicians. A screening process will identify those with tinnitus that impacts health-related quality of life, and following consent smartphone-based audiometry will be performed. Randomisation 1:1 to the Oto app or one-to-one therapist-led tinnitus therapy will be performed centrally by computer, matching groups for age, sex and hearing level. Following participant allocation, the Oto app will be provided for immediate use, or a one-to-one remote therapy appointment booked to occur within approximately 1 week, with up to 6 sessions delivered. Participant outcomes will be collected at 4,12, 26 and 52 weeks via questionnaire and phone call. The primary outcome is the change in Tinnitus Functional Index (TFI) total score measured at 26 weeks following allocation. Adverse events will be recorded. A health economic evaluation in the form of a cost-utility analysis will be performed using data from participant submitted EuroQol 5D-5L and Health Utilities Index Mark 3 scores and resource use data. Trial results will be made publicly available, including a plain English summary.
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Affiliation(s)
- Matthew E. Smith
- University of Cambridge, Cambridge, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | | | - Oliver Rivero-Arias
- Oxford Pharmagenesis, Oxford, United Kingdom
- University of Oxford, Oxford, United Kingdom
| | - Kim Rand
- Oxford Pharmagenesis, Oxford, United Kingdom
- Akershus University Hospital, Nordbyhagen, Norway
| | | | | | | | - Polly Field
- Oxford Pharmagenesis, Oxford, United Kingdom
| | | | - Jameel Muzaffar
- Oto Health, London, United Kingdom
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
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Eimontas J, Gegieckaitė G, Asačiova I, Stičinskaitė N, Arcimavičiūtė L, Savickaitė D, Vaitiekūnaitė-Zubriakovienė D, Polianskis M, Gans J, Beukes E, Manchaiah V, Andersson G, Lesinskas E. Internet-delivered cognitive behavioral therapy for tinnitus compared to Internet-delivered mindfulness for tinnitus: a study protocol of a randomized controlled trial. Trials 2023; 24:269. [PMID: 37046290 PMCID: PMC10100325 DOI: 10.1186/s13063-023-07299-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/05/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Tinnitus affects around 15% of the population and can be a debilitating condition for a sizeable part of them. However, effective evidence-based treatments are scarce. One recommended treatment for tinnitus is cognitive behavioral therapy which has been found to be effective when delivered online. However, more treatments including mindfulness-based interventions have been studied recently in an attempt to facilitate the availability of effective treatments. There are promising findings showing great effects in reducing tinnitus-induced distress and some evidence about the efficacy of such intervention delivered online. However, there is a lack of evidence on how these two treatments compare against one another. Therefore, the aim of this study will be to compare Internet-delivered cognitive behavioral therapy for tinnitus against an Internet-delivered mindfulness-based tinnitus stress reduction intervention in a three-armed randomized controlled trial with a waiting list control condition. METHODS This study will be a randomized controlled trial seeking to recruit Lithuanian-speaking individuals suffering from chronic tinnitus. The self-report measure Tinnitus Handicap Inventory will be used. Self-referred participants will be randomized into one of three study arms: Internet-delivered cognitive behavioral therapy, Internet-delivered mindfulness-based tinnitus stress reduction intervention, or a waiting-list control group. Post-treatment measures will be taken at the end of the 8-week-long intervention (or waiting). Long-term efficacy will be measured 3 and 12 months post-treatment. DISCUSSION Internet-delivered interventions offer a range of benefits for delivering evidence-based treatments. This is the first randomized controlled trial to directly compare Internet-delivered CBT and MBTSR for tinnitus in a non-inferiority trial. TRIAL REGISTRATION ClinicalTrials.gov NCT05705323. Registered on January 30, 2023.
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Affiliation(s)
- Jonas Eimontas
- Department of Clinical Psychology, Institute of Psychology, Vilnius University, Vilnius, Lithuania.
| | - Goda Gegieckaitė
- Department of Clinical Psychology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Irena Asačiova
- Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | | | | | | | | | - Marius Polianskis
- Clinic of Ear, Nose, Throat and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jennifer Gans
- Mindfulness Based Tinnitus Stress Reduction (MBTSR), San Francisco, CA, USA
| | - Eldre Beukes
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, CO, USA
| | - Vinaya Manchaiah
- Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, CO, USA
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO, USA
- UC Health Hearing and Balance, University of Colorado Hospital, Aurora, CO, USA
- University of Pretoria, Pretoria, South Africa
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Eugenijus Lesinskas
- Clinic of Ear, Nose, Throat and Eye Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Shafiro V, Coco L, Preminger JE, Saunders GH. Introduction for the 5th International Meeting on Internet and Audiology Special Issue of the American Journal of Audiology. Am J Audiol 2022; 31:845-848. [PMID: 36108277 PMCID: PMC9886160 DOI: 10.1044/2022_aja-22-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Valeriy Shafiro
- Department of Communication Disorders & Sciences, Rush University, Chicago, IL
| | - Laura Coco
- Oregon Health & Science University, Portland,School of Speech, Language, and Hearing Sciences, San Diego State University, CA
| | - Jill E. Preminger
- School of Speech, Language, and Hearing Sciences, San Diego State University, CA
| | - Gabrielle H. Saunders
- Manchester Centre for Audiology and Deafness, University of Manchester, United Kingdom
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