Rodrigo, H.S., Beukes, E.W., Andersson, G., & Manchaiah, V.
BMJ Open, 11, e049384. doi: 10.1136/bmjopen-2021-049384
Publication year: 2021

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.

Interventions: ICBT.

Primary and secondary outcome measures: The key predictor variables included demographic, tinnitus, hearing-related, and treatment-related variables as well as clinical factors (e.g., 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 1.32-12.51), compared to 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 1.50-4.67) 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 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 to 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.