UNification of Treatments and Interventions for TInnitus Patients - Randomized Clinical Trial (UNITI-RCT)
NCT ID: NCT04663828
Last Updated: 2023-08-14
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
500 participants
INTERVENTIONAL
2021-04-16
2023-06-15
Brief Summary
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Detailed Description
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Prior to the start of the study, potential participants will be online pre-screened with respect to inclusion and exclusion criteria. If the potential candidates are appropriate for a participation, they will be invited for a first visit on-site for a detailed screening of inclusion and exclusion criteria, and of health-related, tinnitus-specific, audiological examinations and electrophysiological measurements (auditory brainstem response, auditory middle latency response). Based on their determined hearing profile the decision will be made, whether there is an indication for the application of a HA. Accordingly, the sample of patients will be stratified into two groups: patients with an HA indication and those without an indication. If such a HA indication does not exist, patients will alternatively receive ST. Within these two groups (hearing aid indication - yes or no), patients will be randomly allocated to the intervention arms consisting of single and combinational interventions.
Single therapy:
* HA (in the group stratified for hearing aids)
* ST
* SC
* CBT4T
Combinational therapy:
* HA + ST (in the group stratified for hearing aids)
* HA + SC (in the group stratified for hearing aids)
* HA + CBT4T (in the group stratified for hearing aids)
* ST + SC
* ST + CBT4T
* SC + CBT4T
Screening and baseline as well as treatment start can be performed on the same day. In this case relevant assessments are only performed once. In addition, blood samples can be obtained during screening, baseline or a separate visit before treatment begin. Blood sampling is voluntary and does not have influence on participation of the study. After the baseline visit the respective intervention will start (at latest 4 weeks after the baseline, otherwise baseline measurements will be repeated) and last for 12 weeks. During an interim assessment after 6 weeks of treatment participants have to complete health-related and tinnitus-specific questionnaires again plus additional assessments of adverse events. Interventions will end after 12 weeks with a repetition of measurements made during baseline and another evaluation of adverse events. A follow-up measurement is planned 9 months after the first visit (baseline measurement). Moreover, an additional voluntary follow-up assessment can be done 12 months after the first visit. Each visit will have a duration of approximately 2-3 hours. Our primary outcome will focus on changes in tinnitus distress measured via the Tinnitus Handicap Inventory (THI; (Newman et al., 1996)). Participants can choose to cancel their participation in the study at any point without reasons or any disadvantages except the missing treatment. Intervention for a single participant can be cancelled in the case of a significant deterioration of tinnitus symptoms. Slight worsening might be possible but expected to short-term. In case of worsening, participants receive support by trained medical and psychological experts. Prior to the start of the study, it will be registered in clinicaltrials.gov. For detailed information about the study procedure, interventions and used measurement please see the attached "UNITI - clinical investigation plan".
Sample A planned sample size of N = 100 patients in Regensburg will be recruited from the clinic and polyclinic for ear, nose and throat medicine as well as from the clinic and polyclinic for psychiatry and psychotherapy both part of the University of Regensburg. Additional recruitment strategies such as marketing via newspaper etc. are planned.
Conditions
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Study Design
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RANDOMIZED
PARALLEL
TREATMENT
NONE
Study Groups
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Structured counseling
Patients will receive a structured counseling therapy
Structured counseling
Structured patient education and counselling is considered as providing information to patients in order to empower them to better manage their disorder
Hearing Aids
Patients will receive hearing aids support
Hearing aids
Hearing aids are considered medical devices and are recommended to patients with a certain degree of hearing loss. Hearing aids amplify environmental sounds.
Cognitive behavioral therapy
Patients will receive cognitive behavioral therapy
Cognitive behavioral therapy
This is a structured intervention and consists of a several week program both with noise exposure and structured interviews and expert-patient as well as patient-patient interaction in groups
Sound therapy
Patients will follow a sound therapy program
Sound therapy
Several sounds and music are used for tinnitus disorder
Combination of sound therapy and cognitive behavioral therapy
Patients will receive a combination of sound therapy and cognitive behavioral therapy
Cognitive behavioral therapy
This is a structured intervention and consists of a several week program both with noise exposure and structured interviews and expert-patient as well as patient-patient interaction in groups
Sound therapy
Several sounds and music are used for tinnitus disorder
Combination of hearing aids and cognitive behavioral therapy
Patients will receive a combination of hearing aids and cognitive behavioral therapy
Hearing aids
Hearing aids are considered medical devices and are recommended to patients with a certain degree of hearing loss. Hearing aids amplify environmental sounds.
Cognitive behavioral therapy
This is a structured intervention and consists of a several week program both with noise exposure and structured interviews and expert-patient as well as patient-patient interaction in groups
Combination of hearing aids and structured counseling
Patients will receive a combination of hearing aids and structured counseling
Structured counseling
Structured patient education and counselling is considered as providing information to patients in order to empower them to better manage their disorder
Hearing aids
Hearing aids are considered medical devices and are recommended to patients with a certain degree of hearing loss. Hearing aids amplify environmental sounds.
Combination of structured counseling and sound therapy
Patients will receive a combination of structured counseling and sound therapy
Structured counseling
Structured patient education and counselling is considered as providing information to patients in order to empower them to better manage their disorder
Sound therapy
Several sounds and music are used for tinnitus disorder
Combination of hearing aids and sound therapy
Patients will receive a combination of hearing and sound therapy
Hearing aids
Hearing aids are considered medical devices and are recommended to patients with a certain degree of hearing loss. Hearing aids amplify environmental sounds.
Sound therapy
Several sounds and music are used for tinnitus disorder
Combination of cognitive behavioral therapy and sound therapy
Patients will receive a combination of cognitive behavioral therapy and sound therapy
Cognitive behavioral therapy
This is a structured intervention and consists of a several week program both with noise exposure and structured interviews and expert-patient as well as patient-patient interaction in groups
Sound therapy
Several sounds and music are used for tinnitus disorder
Interventions
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Structured counseling
Structured patient education and counselling is considered as providing information to patients in order to empower them to better manage their disorder
Hearing aids
Hearing aids are considered medical devices and are recommended to patients with a certain degree of hearing loss. Hearing aids amplify environmental sounds.
Cognitive behavioral therapy
This is a structured intervention and consists of a several week program both with noise exposure and structured interviews and expert-patient as well as patient-patient interaction in groups
Sound therapy
Several sounds and music are used for tinnitus disorder
Eligibility Criteria
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Inclusion Criteria
2. Chronic tinnitus (for at least 6 months based on history)
3. Age 18-80 years
4. Ability to understand and consent to the research / ability to participate (hearing ability, intellectual capacity, no plans for sabbaticals or long-term holidays, no (plans for) pregnancy)
5. A score of \>22 on the Montreal Cognitive Assessment (MoCa), i.e. adults without mild cognitive impairment
6. Ability and willingness to use the UNITI mobile applications on their smartphones
7. A score of ≥ 18 in the Tinnitus Handicap Inventory (THI) of Newman et al. (1996)
8. Willing to use a hearing aid (if indication)
9. If a drug therapy with psychoactive substances (e.g. antidepressants, anticonvulsants) exists at the beginning of the therapeutic intervention, it must have been stable for at least 30 days. The therapy should remain constant during the duration of the study, but a necessary change is not an exclusion criterion. Any change in medication is documented in the CRF.
Exclusion Criteria
2. Start of any other tinnitus related treatments, especially hearing aids, structured counseling, sound therapy (with special devices; expecting long term effects) or cognitive behavioral therapy in the last 3 months before the start of the study
3. Otosclerosis / acoustic neuroma or other relevant ear disorders with fluctuation hearing
4. Present acute infections (acute otitis media, otitis externa, acute sinusitis)
5. Meniere's disease or similar syndromes (but not vestibular migraine)
6. Serious internal, neurological or psychiatric conditions
7. Epilepsy or other CNS disorders (brain tumor, encephalitis)
8. Clinically relevant drug, medication or alcohol abuse up to 12 weeks before study start
9. Missing written informed consent
10. Severe hearing loss - inability to communicate properly in the course of the study
11. One deaf ear
18 Years
80 Years
ALL
No
Sponsors
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University Hospital Regensburg
OTHER
University Hospital Virgen de las Nieves
OTHER
Hospital Clinico Universitario San Cecilio
OTHER
Charite University, Berlin, Germany
OTHER
National and Kapodistrian University of Athens
OTHER
KU Leuven
OTHER
UNITI Consortium
NETWORK
Responsible Party
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Locations
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Tinnituszentrum Regensburg
Regensburg, Bavaria, Germany
Countries
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References
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Schoisswohl S, Langguth B, Schecklmann M, Bernal-Robledano A, Boecking B, Cederroth CR, Chalanouli D, Cima R, Denys S, Dettling-Papargyris J, Escalera-Balsera A, Espinosa-Sanchez JM, Gallego-Martinez A, Giannopoulou E, Hidalgo-Lopez L, Hummel M, Kikidis D, Koller M, Lopez-Escamez JA, Marcrum SC, Markatos N, Martin-Lagos J, Martinez-Martinez M, Martinez-Martinez M, Ferron MM, Mazurek B, Mueller-Locatelli N, Neff P, Oppel K, Perez-Carpena P, Robles-Bolivar P, Rose M, Schiele T, Schiller A, Simoes J, Stark S, Staudinger S, Stege A, Verhaert N, Schlee W. Unification of Treatments and Interventions for Tinnitus Patients (UNITI): a study protocol for a multi-center randomized clinical trial. Trials. 2021 Dec 4;22(1):875. doi: 10.1186/s13063-021-05835-z.
Simoes JP, Schoisswohl S, Schlee W, Basso L, Bernal-Robledano A, Boecking B, Cima R, Denys S, Engelke M, Escalera-Balsera A, Gallego-Martinez A, Gallus S, Kikidis D, Lopez-Escamez JA, Marcrum SC, Markatos N, Martin-Lagos J, Martinez-Martinez M, Mazurek B, Vassou E, Jarach CM, Mueller-Locatelli N, Neff P, Niemann U, Omar HK, Puga C, Schleicher M, Unnikrishnan V, Perez-Carpena P, Pryss R, Robles-Bolivar P, Rose M, Schecklmann M, Schiele T, Schobel J, Spiliopoulou M, Stark S, Vogel C, Wunder N, Zachou Z, Langguth B. The statistical analysis plan for the unification of treatments and interventions for tinnitus patients randomized clinical trial (UNITI-RCT). Trials. 2023 Jul 24;24(1):472. doi: 10.1186/s13063-023-07303-2.
Related Links
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Publication of study protocol
Publication of Statistical Analysis Plan SAP
Other Identifiers
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UNITI
Identifier Type: -
Identifier Source: org_study_id
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