Tinnitus PSP: What’s happening to address the priorities more than 4 years later?

The Tinnitus PSP announced its Top 10 priorities for future research back in July 2012, having received 2,483 questions in response to its initial survey to gather uncertainties about the treatment of tinnitus. This was far from the end of the process! The next step was to ensure that researchers and research funders used the Top 10 priorities to make a real difference to the lives of patients, carers and health professionals.

Professor Deborah Hall from the NIHR Nottingham Hearing Biomedical Research Unit says, “We were the 9th JLA PSP project to have completed, back in 2012, and so in part we felt like pioneers in a brave new world. Success since then is largely thanks to the British Tinnitus Association who not only worked alongside us as collaborators, but also used these patient-centred priorities to inform the charity’s own research strategy, drive fund-raising schemes and raise general awareness. As you can see, there is still a lot more progress to be made, but the Top 10 has definitely brought a clear focus to all of our efforts.”

Deborah has worked with the British Tinnitus Association to keep track of research that is addressing the 10 most important areas of need. You can find much more detail in the Funded Research section of the JLA website.

Here's what has been happening around the Top 10:

Why do people with tinnitus use apps?

Research in progress, supported by The British Tinnitus Association Head of Research, addressing number 1 on the list of priorities.

In this ‘horizon scanning’ study, Magdalena Sereda at the NIHR Nottingham Hearing Biomedical Research Unit will identify apps that people use for tinnitus management, evaluate their content, and assess their potential strengths and limitations through an online survey.

Manualisation and feasibility study of audiologist-delivered counselling for tinnitus

NIHR research in progress, addressing number 2 on the list of priorities.

In this feasibility study, NIHR Nottingham Hearing Biomedical Research Unit staff led by Derek Hoare will develop a manual for audiologists which defines standard care and counselling.

Cognitive Behaviour Therapy for tinnitus-related insomnia

Research in progress commissioned by The British Tinnitus Association, addressing number 3 on the list of priorities.

Sleep disturbance is one of the most common complaints from people with tinnitus affecting between 50-70% of people attending tinnitus clinics. This study, led by Dr Laurence McKenna and Dr Liz Marks, University College London, will investigate the effectiveness of Cognitive Behavioural Therapy as a treatment of tinnitus-related insomnia.

Evaluating the Tinnitus E-Programme, an internet-based self-help programme for tinnitus

NIHR research in progress funded through the NIHR Nottingham Hearing Biomedical Research Unit PhD studentship, addressing number 4 on the list of priorities.

Until a cure for tinnitus is found, people need support to manage their tinnitus and reduce its impact on their everyday lives. Self-help programmes provide one way of achieving this. A systematic review was published in May 2016. The PhD project has also evaluated the Tinnitus E-Programme (www.tinnituseprogramme.org), an internet-based self-help programme for people with tinnitus.

Amplification with hearing aids for patients with tinnitus and co-existing hearing loss

A Cochrane Review was published in January 2014, addressing number 5 on the list of priorities.

Combined amplification and sound generation devices for tinnitus: towards creating clinical guidance and recommended procedure

Research in progress, addressing number 5 on the list of priorities. Supported by the British Society of Audiology Tinnitus and Hyperacusis Special Interest Group. Part-funded by a BSA Applied Research Grant

Ongoing research led by Dr Magdalena Sereda is conducting a series of surveys to 1) identify where there is and is not clinical consensus on who should be recommended combination hearing aids (candidacy) and how those devices should be fitted; 2) explore expectations and experiences of people with tinnitus who have used combination hearing aids.

Tinnitus in children practice guidance

In March 2015, the Paediatric Audiology Interest Group (PAIG) of the British Society of Audiology published practice guidance (.PDF). The guidance offers child-friendly, practical advice for those wanting to develop their skills in the management of children with tinnitus. This project was supported by the British Tinnitus Association and addresses number 6 on the list of priorities.

People's experiences with different degrees of hearing loss and tinnitus

People who are deaf or have profound hearing loss are often marginalised by both their tinnitus and hearing loss. The British Tinnitus Association commissioned The Ear Foundation to investigate people's experiences with different degrees of hearing loss and tinnitus (supported by the James Tudor Foundation). The report was launched in September 2015 and presents the views of 1,432 participants on the treatment they have received, what helped, what didn't and their hopes for the future. This addresses number 7 on the list of priorities.

The QUest In Eliminating Tinnitus (QUIET-1): testing a novel drug for tinnitus

The main aim of this trial was to try to demonstrate an improvement in the severity of tinnitus symptoms and impact after 28 days of treatment with the study medicine compared to placebo. It aimed to address number 10 on the list of priorities. See Nottingham Hearing BRU project page. Findings (.PDF) from the planned interim analysis of completed participants led to the closure of recruitment due to lack of efficacy. On a statistical basis, it would not be possible to reach the magnitude of change needed to show improvement over the placebo. Nevertheless, the team gained many valuable insights about trial design and patient recruitment.

The British Tinnitus Association is also funding a Head of Research fellowship that addresses priorities 1, 4, 5 and 9. Research is in progress. Dr Magdalena Sereda hopes her funded research will shed new light on the clinical efficacy and cost-effectiveness of NHS contracted sound therapy options for tinnitus including hearing aids and combination hearing aids.

You can read more about the work that the Tinnitus PSP did, including a full list of the 386 uncertainties identified, in the PSP final report.