Long-Term Efficacy of Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Tinnitus Purpose The purpose of this study was to investigate the long-term outcomes 1 year after undertaking an audiologist-guided Internet-based cognitive behavioral therapy (iCBT) intervention for tinnitus. Secondary aims were to identify any predictors of outcome and whether there were any unwanted events related to undertaking iCBT for tinnitus. ... Research Article
Research Article  |   November 19, 2018
Long-Term Efficacy of Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Tinnitus
 
Author Affiliations & Notes
  • Eldré W. Beukes
    Faculty of Science and Technology, Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom
  • Peter M. Allen
    Faculty of Science and Technology, Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom
    Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
  • David M. Baguley
    Faculty of Science and Technology, Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom
    National Institute for Health Research, Nottingham Biomedical Research Centre, United Kingdom
    Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, United Kingdom
  • Vinaya Manchaiah
    Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
    Audiology India, Mysore, Karnataka, India
    Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India
  • Gerhard Andersson
    Department of Behavioural Sciences and Learning, Linköping University, Sweden
    Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Eldré W. Beukes, who is now at the Department of Speech and Hearing Sciences at Lamar University, Beaumont, TX: eldre.beukes@anglia.ac.uk
  • Editor-in-Chief: Sumitrajit (Sumit) Dhar
    Editor-in-Chief: Sumitrajit (Sumit) Dhar×
  • Editor: Ariane Laplante-Lévesque
    Editor: Ariane Laplante-Lévesque×
  • Publisher Note: This article is part of the Special Issue: Internet and Audiology.
    Publisher Note: This article is part of the Special Issue: Internet and Audiology.×
Article Information
Hearing Disorders / Special Issue: Internet and Audiology
Research Article   |   November 19, 2018
Long-Term Efficacy of Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Tinnitus
American Journal of Audiology, November 2018, Vol. 27, 431-447. doi:10.1044/2018_AJA-IMIA3-18-0004
History: Received January 8, 2018 , Revised February 28, 2018 , Accepted April 10, 2018
 
American Journal of Audiology, November 2018, Vol. 27, 431-447. doi:10.1044/2018_AJA-IMIA3-18-0004
History: Received January 8, 2018; Revised February 28, 2018; Accepted April 10, 2018

Purpose The purpose of this study was to investigate the long-term outcomes 1 year after undertaking an audiologist-guided Internet-based cognitive behavioral therapy (iCBT) intervention for tinnitus. Secondary aims were to identify any predictors of outcome and whether there were any unwanted events related to undertaking iCBT for tinnitus.

Method Participants who had previously undertaken a randomized iCBT efficacy trial for tinnitus were invited to participate. Of the 146 who were initially randomized for the efficacy trial, 104 participants completed the 1-year postintervention assessment measures. The primary outcome was a change in tinnitus distress as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for insomnia, anxiety, depression, hearing handicap, hyperacusis, cognitive failures, and satisfaction with life. An intention-to-treat analysis using repeated-measures analysis of variance and hierarchical multiple regression was used for statistical analysis. Unwanted effects were categorized according to the unwanted events checklist.

Results Undertaking iCBT for tinnitus led to significant improvements 1 year postintervention for tinnitus and related difficulties, for example, insomnia, anxiety, depression, hearing handicap, hyperacusis, and life satisfaction. The best predictors of improving tinnitus severity at 1-year postintervention were greater baseline tinnitus severity scores, reading more of the modules, and higher satisfaction with the intervention. Unwanted events were reported by 11% of the participants and were more likely to be reported by women than men. These events were related to worsening of symptoms, the emergence of new symptoms, negative well-being, and prolongation of treatment.

Conclusions The clinical benefits of audiologist-guided iCBT for tinnitus and tinnitus-related difficulties were sustained 1 year postintervention. Predictors of outcome indicated that the intervention is applicable to a wide range of participants regardless of their demographic backgrounds. Attempts should be made to minimize unwanted events in subsequent trials.

Acknowledgments
Anglia Ruskin, Lamar, and Linköping Universities and the National Institute for Health Research, Nottingham, supported the undertaking of this study, but the views expressed are those of the authors and not of these institutions. Portions of this article were presented at the third International Internet & Audiology Meeting, Louisville, KY, in July 2017. The conference committee is thanked for providing a travel bursary for the first author to present this work at the conference. The authors wish to thank all participants and organizations that promoted and supported this study. They would also like to thank Linköping University for hosting the web portal and their webmaster, George Vlaescu, for the technical assistance provided.
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