Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 4, 2014
   Pages 609 — 622

Abstract — Development of a progressive audiologic tinnitus management program for Veterans with tinnitus

Paula J. Myers, PhD;1* Susan Griest, MPH;2–3 Christine Kaelin, MBA;2 Marcia W. Legro, PhD;2 Caroline J. Schmidt, PhD;4 Tara L. Zaugg, AuD;2 James A. Henry, PhD2–3

1James A. Haley Veterans’ Hospital, Tampa, FL; 2Department of Veterans Affairs (VA) Rehabilitation Research and Development, National Center for Rehabilitative Auditory Research, Portland, OR; 3Department of Otolaryngology/Head & Neck Surgery, Oregon Health & Science University, Portland, OR; 4VA Connecticut Healthcare System, West Haven, CT; and Department of Psychiatry, Yale University School of Medicine, New Haven, CT

Abstract — 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.

Key words: auditory disorders, hearing disorders, outcome and process assessment (health care), pilot projects, Progressive Audiologic Tinnitus Management, tinnitus, tinnitus intervention, treatment outcome, VA audiology, Veterans.


View HTML ¦ View PDF ¦ Contents Vol. 51, No.4

This article and any supplementary material should be cited as follows:
Myers PJ, Griest S, Kaelin C, Legro MW, Schmidt CJ, Zaugg TL, Henry JA. Development of a progressive audiologic tinnitus management program for Veterans with tinnitus. J Rehabil Res Dev. 2014;51(4):609–22.
http://dx.doi.org/10.1682/JRRD.2013.08.0189
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