/wp-content/uploads/2016/09/tinnitus-treatment-research-thousand-oaks.jpg” alt=”tinnitus-treatment-research-thousand-oaks” width=”600″ height=”377″ class=”alignnone size-full wp-image-2103″ />
Many Physicians Don’t Follow Guidelines
Perhaps the most interesting aspect of this study was the lack of adherence on the part of physicians to follow recent evidence-based tinnitus management guidelines. These AAO-HNS guidelines are designed to address patients with tinnitus that has persisted more than six months.
These guidelines were intended to provide a framework for how patients with tinnitus are evaluated and managed in the clinic, as they are intended to provide evidence — both for and against – the use of education, counseling, sound therapy, cognitive behavioral therapy, medications, dietary supplements, and other various management approaches. The guidelines recommend that clinicians should not use medical therapy, including anti-depressant, anticonvulsants and intratympanic medications for routine management of tinnitus because there is insufficient data supporting their effectiveness.
In the Bhatt et al study, it was reported that 49.5% of individuals with tinnitus discussed it with their physician. Their survey also found 84.8% of patients had never tried any form of remedy, and that the most common intervention discussed by physicians was medication – a recommendation not supported by the 2014 AAO-HNS guidelines for routine cases of tinnitus.
It is also noteworthy that even though the AAO-HNS tinnitus guidelines recommend that a hearing aid evaluation is an appropriate management option, it was rarely discussed by physicians.
Although not supported by solid evidence, the guidelines also encourage physicians to present sound therapy (masking devices) as an option, but according to this study it too was rarely made available to patients.
According to UC-San Francisco clinical psychologist & founder of MindfulTinnitusRelief, Dr. Jennifer Gans:
“This study shines light on tinnitus as a major public health concern and with awareness comes more critical investigation and better management recommendations from doctors on the front-line of care. The search for better tinnitus management forces us to step outside-of-the-box and to look at how mental habits and erroneous thinking may in fact be preventing us from healing. While we cannot look, at this time, to a pill or operation to “cure” tinnitus, there are multiple effective management tools to help shift tinnitus from the ‘bothersome’ category into the non-bothersome’ category. What I have found in my work is that it is the ‘stories’ and often erroneous thoughts in which we wrap our experience with tinnitus that keeps it stuck in the ‘bothersome’ category. When we start to unravel this knot of beliefs, we can then allow the natural habituation process to take place. Mindfulness and cognitive behavioral counseling may not be as easy to administer as a pill or surgical intervention, but what we are learning is that the management of bothersome tinnitus involves changing one’s perspective. Therapy emphasizing mindfulness and a cognitive shift or ‘letting go’ of suffering around the tinnitus sensation allows the brain to relax enough to allow the natural habituation process to take place.”
Given that more than 50% of the individuals in this recent survey reported persistent tinnitus that had lasted more than five years, and fewer than one on four patients who discussed their tinnitus with their physician received management recommendations consistent with the 2014 evidence-based AAO-HNS guidelines, the audiology community has ample opportunities to provide effective long-term tinnitus management strategies, including the recommendation of hearing aids and sound relief devices.
Current Tinnitus Management Patterns Represent Big Opportunities for Audiology Community