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Progressive Tinnitus Management at Two Veterans Affairs Medical Centers: Clinical Implementation With Modified

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Modified progressive tinnitus management (PTM) protocols at two Veterans Affairs medical centers demonstrated positive outcomes for veterans. Adaptations to PTM can enhance treatment effectiveness for tinnitus management.

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Area of Science:

  • Audiology
  • Clinical Psychology
  • Evidence-Based Practice

Background:

  • Progressive Tinnitus Management (PTM) is an evidence-based approach for tinnitus.
  • Standardized protocols may require adaptation for diverse clinical settings.
  • Veterans Affairs (VA) medical centers provide a unique context for implementing PTM.

Purpose of the Study:

  • To describe the clinical implementation and outcomes of modified PTM protocols at two VA medical centers.
  • To evaluate the impact of clinician-directed modifications on patient outcomes.
  • To compare outcomes of modified PTM with existing PTM clinical trial data.

Main Methods:

  • Two VA PTM programs modified the standard PTM protocol, with modifications classified using an evidence-based framework.
  • Pre-post outcome measures were analyzed for veterans completing the Iowa City (n=20) and Asheville (n=200) programs.
  • Outcomes from the Asheville program were compared to a PTM developer's clinical trial.

Main Results:

  • Veterans in the Iowa City program showed a significant decrease in Tinnitus Handicap Inventory scores.
  • Veterans in the Asheville program showed a significant decrease in Tinnitus Functional Index (TFI) scores.
  • The Asheville program achieved greater mean TFI reduction and a larger effect size than the PTM developer's trial.

Conclusions:

  • Clinician-directed modifications to PTM can lead to positive patient outcomes.
  • Adapting PTM protocols to local needs may enhance treatment effectiveness.
  • Reporting outcomes of PTM modifications is encouraged to advance understanding of evidence-based practice adaptation.