Initial compliance as a predictor of therapeutic outcomes in chronic tinnitus

Tinnitus treatments incorporate various strategies, yet substantial challenges remain. Sound therapy (ST) is cost-effective and self-administered, but its efficacy and standardization continue to be debated. This study aimed to evaluate treatment outcomes and associated factors of ST combined with reinforced directive counseling (DC) in patients with chronic tinnitus. From January 2020 to August 2023, 53 patients underwent one year of ST-based self-training, with reinforced DC provided every 6 months. Tinnitus distress was assessed using the numeric rating scale (NRS, 0-100), tinnitus handicap inventory (THI), and visual analogue scale. The treatment-response group (N = 33) engaged in more frequent (P < .001) and longer ST sessions (P = .001) than the non-response group (N = 20) during the first 6 months, and maintained higher session frequency over 12 months (P = .037). High adherence to ST (>30 minutes/session, ≥2.5 times/week) during the initial 6 months led to significant improvements in NRS scores at both 6 months (P < .001) and 12 months (P = .013), as well as improved tinnitus awareness at 12 months (P = .018). High adherence to ST self-training during the initial 6 months significantly alleviated tinnitus-related distress. Patients with chronic tinnitus should be informed of the importance of maintaining consistent engagement during the early phase of therapy.