Tinnitus management in Ireland: a pilot study of general practitioners
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ORIGINAL ARTICLE
Tinnitus management in Ireland: a pilot study of general practitioners Naomi Kilroy 1 & Amr El Refaie 1 Received: 19 November 2019 / Accepted: 25 March 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background Tinnitus is a phenomenon that affects approximately 15% of the adult population. A minority of patients will experience chronic bothersome tinnitus that has a detrimental effect on their quality of life. Management of such tinnitus is challenging for healthcare practitioners. Primary care services are the first point at which patients seek expert medical advice about their condition and General Practitioners (GPs) must be equipped with the knowledge to appropriately triage and guide patients. Aims To date, there has been little research surrounding tinnitus management in Ireland. The aim of this study is to determine how GPs assess and manage tinnitus patients in Ireland. Methods This is a quantitative study in the form of an online survey. The 15-item questionnaire was made available through SurveyMonkey and was distributed by email to GPs in Cork, Kerry and South Dublin. Results The survey obtained 43 responses. Sixty-three percent of GPs do not follow any routine criteria for onward referral. Forty percent feel that tinnitus has sufficient impact on their practice to warrant further training. GPs expressed a need for clearer guidance on tinnitus management and better access to resources such as ENT (ear nose throat), MRI (magnetic resonance imaging) and audiology. Conclusions This study demonstrates there is wide variation in how tinnitus is evaluated and managed by GPs, which represents a gap in clinical care. We recommend further research, implementation of a service model for tinnitus, national clinical guidelines, training pathways for primary care staff and establishment of regional direct-access tinnitus clinics throughout Ireland. Keywords Audiology . General practitioners . Primary health care . Quality of life . Tinnitus . Triage
Background and rationale Tinnitus is defined as the perception of sound in the absence of an external source [1]. The condition is highly complex with multifactorial origins. Epidemiological studies suggest 10– 20% of all adults throughout the world experience tinnitus
* Amr El Refaie [email protected] Naomi Kilroy [email protected] 1
Department of Speech and Hearing, School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork T12 EK59, Ireland
[2], with approximately one in three elderly adults reporting chronic tinnitus [3]. Negative consequences associated with tinnitus include psychological distress, sleep deprivation, impaired concentration and inability to work [4]. Chronic tinnitus can lead to significant social, emotional and economic burdens resulting in reduced quality of life (QOL) for both the patient and their family. Tinnitus that is primary in nature includes idiopathic tinnitus, noise-induced tinnitus and, most commonly, tinnitus associated with hearing loss. Secondary tinnitus is
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