School of Mathematical and Statistical Sciences Faculty Publications and Presentations
Internet-based cognitive–behavioural therapy for tinnitus: secondary analysis to examine predictors of outcomes
Objectives The current study examined predictors of outcomes of internet-based cognitive–behavioural therapy (ICBT) for individuals with tinnitus.
Design Secondary analysis of intervention studies.
Setting Internet-based guided tinnitus intervention provided in the UK.
Participants 228 individuals who underwent ICBT.
Primary and secondary outcome measures The key predictor variables included demographic, tinnitus, hearing-related and treatment-related variables as well as clinical factors (eg, anxiety, depression, insomnia), which can have an impact on the treatment outcome. A 13-point reduction in Tinnitus Functional Index (TFI) scores has been defined as a successful outcome.
Results Of the 228 subjects who were included in the study, 65% had a successful ICBT outcome. As per the univariate analysis, participants with a master’s degree or above had the highest odds of having a larger reduction in tinnitus severity (OR 3.47; 95% CI 1.32 to 12.51), compared with the participants who had education only up to high school or less. Additionally, the baseline tinnitus severity was found to be a significant variable (OR 2.65; 95% CI 1.50 to 4.67) contributing to a successful outcome with the intervention. Both linear and logistic regression models have identified education level and baseline tinnitus severity to be significant predictor variables contributing to a reduction in tinnitus severity post-ICBT. As per the linear regression model, participants who had received disability allowance had shown a 25.3-point lower TFI reduction compared with those who did not experience a decrease in their workload due to tinnitus after adjusting for baseline tinnitus severity and their education level.
Conclusions Predictors of intervention outcome can be used as a means of triaging patients to the most suited form of treatment to achieve optimal outcomes and to make healthcare savings. Future studies should consider including a heterogeneous group of participants as well as other predictor variables not included in the current study.
ClinicalTrial.gov Registration: NCT02370810 (completed); NCT02665975 (completed)
Rodrigo H, Beukes EW, Andersson G, et al. Internet-based cognitive–behavioural therapy for tinnitus: secondary analysis to examine predictors of outcomes. BMJ Open 2021;11:e049384. doi:10.1136/ bmjopen-2021-049384
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ