Understanding and improving patient care in Audiology
Our focus at Aston is on understanding and improving patient care in Audiology. We lead projects ranging from population level studies of associations to look for patterns in health experience to studies examining individual coping. Our approach to tinnitus research is to target patient care and to understand better the mechanisms that are important in treating tinnitus distress. As tinnitus perception is often reduced with reduced distress this, in turn, treats tinnitus.
In collaboration with the British Tinnitus Association we have conducted ground breaking studies of clinical interactions, understanding the features that help and hinder patients as they navigate their care. We have conducted the first full study of patient preferences and values and identified patient priorities for their care (1), including the importance of information. This work has led to the first international standard Decision Aid for tinnitus to support shared decision making between people with tinnitus and their clinicians.
To support clinicians in developing shared decision making, we have produced example videos to explain how to introduce choices and weigh up options. (https://www.tinnitus.org.uk/decision-aid). Furthermore we have supported a network of clinical service evaluations which reveal that including the decision aid increases patient confidence and satisfaction in their care.
Our research team have explored the active ingredients of tinnitus support groups and have identified features of these groups that improve coping, reducing distress and perception of tinnitus (2). We have worked alongside the BTA to ensure that these findings are adopted in their practices, improving training and support for tinnitus groups and providing guidance on their management.
We have been the first researchers to describe the patient experience from examinations of how thinking about tinnitus alters the way it is experienced (3) to examining coping behaviours. We do this because we need to understand the complex mechanisms that influence perception to develop and target interventions.
Tinnitus research in the future needs to encompass a range of approaches to understand both how tinnitus is generated, but also what influences perception and interpretation. In some ways understanding the huge variation in individual perception and interpretation are most important because that is what creates distress. In doing so, I hope we continue to develop a better understanding of the variations that exist and get better at tailoring care to people. We have made some strides in understanding that the ‘one size fits all’ approach can and does harm.
Currently we are working on projects to understand what it is that patients benefit from when they use white noise and what patterns of psychological, health and social experience are associated with tinnitus distress.
We are grateful to the BTA for their support to our research.
- Pryce, H., Hall, A., Shaw, R., Culhane, B. A., Swift, S., Straus, J., & Claesen, B. (2018). Patient preferences in tinnitus outcomes and treatments: a qualitative study. International journal of audiology, 57(10), 784-790. https://doi.org/10.1080/14992027.2018.1484184
- Pryce, H., Moutela, T., Bunker, C., & Shaw, R. (2019). Tinnitus groups: A model of social support and social connectedness from peer interaction. British journal of health psychology, 24(4), 913-930. https://doi.org/10.1111/bjhp.12386
- Pryce, H., & Chilvers, K. (2018). Losing silence, gaining acceptance: a qualitative exploration of the role of thoughts in adult patients with subjective tinnitus. International journal of audiology, 57(11), 801-808. https://doi.org/10.1080/14992027.2018.1500041