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The prevalence of tinnitus in military veterans is notably higher than the non-veteran population and can significantly disrupt the lives of veterans. Given the profound impact of tinnitus on the lives of veterans, along with the considerable economic burden and barriers to treatment, it is crucial to explore the feasibility of new approaches. Wearable sound technologies offer a non-invasive and easily accessible approach. As such, this waitlist-controlled trial aims to assess the efficacy of this new non-invasive white noise wearable device in reducing tinnitus symptoms between baseline and the one-month post-randomisation among veterans who have experienced tinnitus for at least three months.
The presence of tinnitus has been significantly associated with depression, anxiety, sleep difficulties and job performance in addition to poorer general physical health.. However, to our knowledge, there is currently no intervention for tinnitus that is supported as effective for most people. As such, there is a need to explore alternative approaches. Sound therapy offers an easily accessible, non-invasive, low-cost option. As such, this study aims to explore the effectiveness of a non-invasive white noise device in reducing symptoms of tinnitus and mental health difficulties in military veterans. A total of 20 military veterans who have self-reported experiencing tinnitus for at least three months will be recruited. : In this waitlist-controlled trial, the tinnitus device will be compared to the waitlist-controlled group who will receive the device one-month post-randomisation. The trial will be conducted in a veteran population (n = 20) that was recruited from a prior study that had aimed to explore the impact of tinnitus on wellbeing within a veteran population. Once the participants receive the tinnitus device, they will be asked to use the device for a period of one month. The primary outcome is the change in self-reported tinnitus symptoms and mental health difficulties between baseline (day 0) and the one-month post-randomisation (day 28). The outcome variables of interest will be assessed at all timepoints (baseline, one-month post-randomisation, and two-months post-randomisation) and the predictor variables will only be assessed at baseline to reduce participant burden. It is hypothesised that the non-invasive device will result in significant reductions in symptoms of tinnitus (as indicated using the TFI) and mental health difficulties (as measured using the gHQ-12) from baseline to one-month post-intervention in comparison to a waitlist control.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Immediate intervention arm | Experimental | All participants will receive the non-invasive device to their registered address and will be asked to use it for a period of one month. This will involve wearing the device around ones neck or body during the day and docking it at night for 24/7 relief. Participants can alter the volume and frequency of the device to fit into their individual experience. |
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| Waitlist control arm | Other | The WL control group will receive the device one-month post-randomisation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| White noise device | Device |
|
| Measure | Description | Time Frame |
|---|---|---|
| Symptoms of tinnitus measured using the Tinnitus Functional Index (TF) | Scores range from 0-250, with higher scores indicating greater tinnitus symptoms | [Time Frame: Change from baseline TFI score at one-month post-randomisation and two-months post-randomisation] |
| Symptoms of mental health difficulties measured using the General Health Questionnaire-12 | Scores range from 0-36, with higher scores indicating greater psychological distress | [Time Frame: Change from baseline General Health Questionnaire-12 score at one-month post-randomisation and two-months post-randomisation] |
| Measure | Description | Time Frame |
|---|---|---|
| Satisfaction of life as measured using the Satisfaction with life Scale (SWLS) | Scores range from 5-35, with a higher score indicating greater life satisfaction. | [Time Frame: Change from baseline SWLS score at one-month post-randomisation and two-months post-randomisation] |
| Sleep as measured using the Insomnia Severity Index (ISI) |
| Measure | Description | Time Frame |
|---|---|---|
| Symptoms of PTSD as measured using the Posttraumatic Stress Disorder Checklist For Diagnostic and Statistical Manual of Mental Disorders-5- Short Version (PCL- 5-4) | A 4-item measure of the presence of PTSD symptoms according to the Diagnostic and Statistical Manual of Mental Disorders-IV. Scores range from 0-16, with a higher score indicating more severe PTSD | [Time Frame: Predictor variable] |
Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Combat Stress | Leatherhead | KT22 0BX | United Kingdom |
No identifiable information will be shared with other researchers.
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| ID | Term |
|---|---|
| D014012 | Tinnitus |
| ID | Term |
|---|---|
| D006311 | Hearing Disorders |
| D004427 | Ear Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D012678 | Sensation Disorders |
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Waitlist-controlled trial
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Scores range from 0-28, with a higher score indicating greater insomnia severity. |
| [Time Frame: Change from baseline ISI score at one-month post-randomisation and two-months post-randomisation] |
| Physical health and somatic symptoms as measured using the Patient Health Questionnaire-15 | Scores range from 0-30, with higher scores indicating greater severity of physical health and somatic symptoms | [Time Frame: Predictor variable] |
| Qualitative questionnaire | Consenting participants will be contacted at one-month post-randomisation for the immediate intervention group and two-months post-randomisation for the waitlist control group | [Time Frame: Consenting participants will be contacted at one-month post-randomisation for the immediate intervention group and two-months post-randomisation for the waitlist control group] |
| Retention rate | Feasibility endpoint | [Time Frame: Intervention end (approximately 1 year)] |
| • Recruitment of target sample size (n = 20) | Feasibility endpoint | [Time Frame: Study end (approximately 1 year)] |
| Incidence of adverse events across the duration of the study | Safety endpoint, calculated as total number of adverse events reported across the study. Adverse events as defined in the study protocol. Adverse events will be reported in the qualitative questionnaire post-intervention. | [Time Frame: Study end (approximately 1 year)] |
| D009461 |
| Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |