Evaluation of 5536 patients treated in an integrative outpatient tinnitus treatment center-immediate effects and a modeling approach for sustainability

BACKGROUND

Tinnitus is an increasingly serious problem for health care systems. According to epidemiological data, 7-14 % of outpatients have asked their physician about tinnitus and management strategies. Integrative outpatient treatments are currently regarded as promising therapeutic approaches for managing tinnitus. In this article we report on the treatment success of an outpatient tinnitus treatment center in Germany.

METHODS

This cohort study included pre-post data of 5536 outpatients which were treated between 2003 and 2010 in the tinnitus-therapy center, Krefeld-Düsseldorf (TTZ). The intervention consisted of psychological immunization training as well as an auditory stimulation therapy component. The main outcome parameter was the score of the Tinnitus Questionnaire (TQ) which was assessed before and after a 9 days treatment and (in a small subsample) at a 6 months follow-up. Missing data were multiply imputed. Pre-post effect sizes were calculated and adjusted for regression to the mean (RTM).

RESULTS

RTM-adjusted treatment effects at the end of treatment were estimated as -18.6 (CI: -18.9 to 18.2, p < 0.001) score points which corresponds to a standardized effect of d = -1.03 (CI: -1.05 to -1.01). These effects can be corroborated in various subgroups and all subscales of the TQ (d ranging from -0.31 to -0.97).

CONCLUSION

The study suggests the effectiveness of this outpatient tinnitus therapy concept. Multiple imputations techniques and RTM analysis were helpful in carving out true treatment effects.

[Distraction and relaxation training in acute tinnitus : effects of a complement to otorhinolaryngological treatment]

BACKGROUND

We examined whether training conceptualized as a complement to standard medical treatment (ST) for acute tinnitus to promote patients' capacity to distract attention from their tinnitus and to relax (distraction and relaxation training) has a positive effect on tinnitus-specific distress (tinnitus loudness, tinnitus-related distress and disability), as well as on general well-being.

PATIENTS AND METHODS

Study participants comprised 29 patients with tinnitus of maximum 4 weeks' standing (first lifetime tinnitus episode) who were randomized to ST (rheological therapy) or advanced standard treatment (AST) (rheological therapy complemented by distraction and relaxation training).

RESULTS

Tinnitus-specific distress was reduced to a significantly greater extent in the EST group as compared to ST, especially in patients with a striking psychopathology. The improvement in general well-being was comparable in both groups.

CONCLUSION

In acute tinnitus, distraction and relaxation training should be conducted as a complement to standard medical treatment, especially in high-risk patients demonstrating abnormal psychopathological status, since treatment results can be improved in this way.