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Cited by 24Hearing, Cochlea, Tinnitus, GeneticsHearing Loss and RehabilitationTelemedicine and Telehealth Implementation

Effectiveness of telerehabilitation interventions for self-management of tinnitus: systematic review

Open access
Demoen, Sara, Chalimourdas, Antonios, Timmermans, Annick, Van Rompaey, Vincent, Vanderveken, Olivier M, Jacquemin, Laure, Schlee, Winfried, Marneffe, Wim +3 more·2023·Journal of Medical Internet Research
DOI 10.2196/39076PMC PMC9951082
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Abstract

BACKGROUND: Tinnitus is a highly prevalent symptom affecting 10%-20% of the adult population. Most patients with tinnitus have chronic tinnitus, which can directly or indirectly disrupt their daily life and negatively affect the health-related quality of life. Therefore, patients with tinnitus are frequently in need of costly and time-consuming treatments. As an answer, telerehabilitation interventions are on a rise to promote self-management in patients with tinnitus and reduce their dependency on in-person care. OBJECTIVE: This systematic review aimed to provide an overview of the research concerning the effectiveness of telerehabilitation interventions for self-management of tinnitus. METHODS: This systematic review adheres to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were eligible for inclusion if study participants were adult patients with complaints of primary subjective tinnitus and the study intervention comprised any possible telerehabilitation form for the self-management of tinnitus complaints. A search for eligible studies was conducted on PubMed, ScienceDirect, Scopus, Web of Science, and Cochrane Library. The Cochrane Risk of Bias 2 tool was used to the assess risk of bias. RESULTS: In total, 29 articles were found eligible, and of these, 5 (17%) studied multiple telerehabilitation forms. Internet-based cognitive behavioral treatment with guidance by a psychologist or audiologist was examined in 17 studies (n=1767), internet-based cognitive behavioral treatment without guidance was examined in 4 studies (n=940), self-help manuals were examined in 1 study (n=72), technological self-help devices were examined in 2 studies (n=82), smartphone apps were examined in 8 studies (n=284), and other internet-based interventions were examined in 2 studies (n=130). These rehabilitation categories were proven to be effective in decreasing tinnitus severity and relieving tinnitus distress as measured by tinnitus questionnaires such as Tinnitus Functional Index, Tinnitus Handicap Inventory, or Tinnitus Reactions Questionnaire. However, dropout rates were often high (range 4%-71.4%). All studies reported between some concerns and high concerns of risk of bias, resulting in low to moderate certainty levels. CONCLUSIONS: Overall, there is low to moderate quality evidence that telerehabilitation interventions effectively reduce tinnitus severity and distress. These interventions form a possible tool to improve the self-management capacities of the patient and the accessibility of tinnitus care as a replacement or an addition to in-person care. Nevertheless, barriers such as lack of time, engagement, motivation, and openness of the patient causing high dropout should be considered. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021285450; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=285450.

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  • Post-treatment dropout rates for unguided iCBT for tinnitus range from 16.1 to 37%, with follow-up dropout rates reaching 42.9%.

    “A systematic review evaluating four studies of unguided iCBT for tinnitus reported post-treatment dropout rates ranging from 16.1 to 37%, with follow-up dropout rates reaching 42.9% (Demoen et al., 2023).”

    From Research trends and hotspots of cognitive behavioral therapy for tinnitus: a bibliometric analysis (2025) · cites this paper as Demoen et al., 2023

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  1. [19]Jastreboff PJ Jastreboff MM How TRT derives from the neurophysiological model Proceedings of the 6th International Tinnitus Seminar 1999 ITS '99 September 5-9, 1999 Cambridge, UK 87 91

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Authors
Demoen, S., Chalimourdas, A., Timmermans, A., Van Rompaey, V., Vanderveken, O. M., Jacquemin, L., Schlee, W., Marneffe, W., Luyten, J., Gilles, A., & Michiels, S.
Affiliations
  • University of Antwerp (BE)
  • Hasselt University (BE)
  • University of Regensburg (DE)
  • HOGENT University of Applied Sciences and Arts (BE)
  • Antwerp University Hospital (BE)
Corresponding author
Demoen, Sara
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2023-02-09
Volume
25
Pages
e39076
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/39076
PMC
PMC9951082
OpenAlex
W4319657163
Cited by
24
References
102
Citations by year
2026: 2 · 2025: 12 · 2024: 8 · 2023: 2
FWCI
1.13
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Document Server@UHasselt (UHasselt) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Vlaamse regering
Topics
  • Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
tinnitus, telerehabilitation, self-management, mobile application, tinnitus distress, tinnitus severity, dropout rates, self-help devices, telemedicine, health-related quality of life, risk of bias, Tinnitus Functional Index, Tinnitus Handicap Inventory
MeSH terms
Telerehabilitation, Self-Management, Adult, Humans, Quality of Life, Self Care, Tinnitus

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