Article

Tinnitus is the most prevalent service-connected disability awarded to Veterans.
However, clinical protocols for management of tinnitus have been inconsistent
across Department of Veterans Affairs (VA) medical centers. A study was funded to
develop and pilot test a protocol to provide tinnitus services consistently
across VA audiology clinics. Drawing on a series of prior VA and external
research projects, a clinical model was formulated, supporting materials in
multimedia were developed, and a pilot study was conducted. Five hierarchical
levels of care were defined and labeled the Progressive Audiologic Tinnitus
Management (PATM) model. The model facilitates access to medical services for
tinnitus and includes detailed protocols for evaluation, education, and
counseling of patients. Patients at each level of care have the option to
"progress" to the next level of PATM if further services are required. Clinical
procedures were defined for each level and materials were produced for
audiologists and patients. The PATM model was then piloted with clinical patients
at the James A. Haley Veterans' Hospital (JAHVH) in Tampa, Florida. Throughout
the pilot study, feedback from patients and clinicians was carefully noted.
Training materials for audiologists, incorporation of the protocol into clinic
activities, and patient outcomes were evaluated. The model was implemented within
the JAHVH Audiology Clinic and to assist Veterans with tinnitus management. The
most notable finding was how little tinnitus-specific intervention was required
for the majority of patients. This finding supports a clinical model that offers
stepped-care ("progressive") levels of care until tinnitus management is achieved
by the patient.

Langue : ANGLAIS