Audit of Current Care Pathways for Tinnitus: INTEGRATE ACCEPT Audit

Introduction: Tinnitus affects ~14% of the population, often causing distress and affecting quality of life. Despite its frequency in outpatient clinics, understanding of its pathophysiology and optimal management strategies remains poor, and there is limited guidance available to clinicians. Aim: To audit UK tinnitus care pathways to gain better understanding of the presentation, investigation, and management of patients with tinnitus. Methods: A collaborative multicentre retrospective audit was conducted nationally across ENT, Audiology and AVM services within the UK. Anonymised data were collected on adults presenting between August-October 2022. These included: demographics, medical history, tinnitus features, associated symptoms, examination findings, audiometry, investigation results, management, and outcomes. Results: Thirty-six sites submitted data for 1,136 patients. 824 patients (73%) were found to have some form of hearing loss on audiometric testing, with nearly two-fifths of these (38%) receiving hearing aid provision. The most common management strategies were self-management techniques (52%), relaxation techniques (26%), sound generators (5%) and masking devices (4%). 46 patients (4%) received CBT. Almost all patients (94%) had no tinnitus questionnaires used for documenting the severity of their symptoms, and only two patients in the whole cohort had follow-up questionnaires used to monitor progression or improvement. Conclusions: Previous reviews of tinnitus practice have relied on questionnaires sent to departments rather than reviewing granular data in hospital records. This work provides analysis of a large group of patient journeys through tinnitus services. It highlights a gap in monitoring and follow-up of these patients and will be useful in shaping future pathways.