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Evidence review for combinations of management strategies: Tinnitus: assessment and management: Evidence review P #MMPMID32437110
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Evidence review for combinations of management strategies: Tinnitus: assessment and management: Evidence review P-/-NICE Evidence Reviews Collection 2020[Mar]; ä (ä): ä PMID32437110show ga
Practice across the UK varies greatly for people with tinnitus. Commonly, treatment strategies include sound therapy, psychological therapies, counselling/ tinnitus support and amplification devices. Some people are offered only one of these approaches, while others are offered more than one or a combination of approaches. Some people with tinnitus find that using sound to manage tinnitus is helpful, while others report that being able to respond differently to their tinnitus is important to them. How decisions are made for people accessing a particular approach also varies greatly, with some people not being actively involved in the decisions about their care. For the purpose of this guideline, the term 'tinnitus support' is favoured over 'tinnitus counselling' and is defined as an interactive process between the individual with tinnitus and healthcare professional. Within this, the concerns and needs of the individual are identified and explored, including difficulties associated with tinnitus and the individual's understanding of the emotions related to tinnitus. As part of this process, delivery of information about tinnitus involves a two-way discussion promoting an understanding of the tinnitus. Then, a management plan can be developed that is tailored to the individual. The individual is supported to understand why suggested strategies may be helpful and how they can go about putting these in to place. As the tinnitus support is individually focused, consideration is made with regard to the needs, age and ability of the individual to ensure that all information is made accessible to them. Where other needs are identified, for example mental health needs, the person with tinnitus may also benefit from being to be referred to other relevant services. The purpose of this review is to determine the effectiveness of using a combination of approaches. Separate reviews look at the clinical and cost effectiveness of amplification devices and sound therapy (evidence review M), psychological therapy (evidence review L) and tinnitus support (evidence review A) alone.