Effect of educational counseling alone on people with tinnitus: Meta-analysis of randomized controlled trials

Objective: To review and meta-analyze the efficacy of educational counseling alone in tinnitus. Methods: We collected randomized controlled trials (RCTs) adhered to PRISMA guidelines. Analyzed the effect of educational counseling alone versus other forms of therapy (psychological or combination) with RevMan 5.3. Results: In nine trials, 582 patients receiving educational counseling alone and 759 patients receiving other psychological or combination therapies. During the 3-6 months follow-up, there was no significant difference in the tinnitus recovery rate between these two groups (OR 0.62, 95% CI 0.34-1.16, P = 0.14; I-2 = 71%, P = 0.00, random-effects model). The tinnitus symptom severity rates were also similar during 112 months follow-up (mean difference, 3.59, 95% CI -0.56-7.74, P = 0.09) with heterogeneity among studies (I-2 = 74%, P = 0.00; random-effects model). Sensitivity analysis indicated that a single trial containing almost 40% of the patients was the cause of heterogeneity. There was no significant change in tinnitus loudness at the 3 months follow-up (OR 0.84, 95% CI 0.42-1.66, P = 0.61), with no significant heterogeneity (I-2 = 0%, P = 0.60). Conclusion: Educational counseling alone helps to improve tinnitus and related problems, and has the same effect as other psychological or combination therapies. Practice Implications: The results of the current analysis may help to develop evidence-based cost-effective treatment(s) for tinnitus, which will be minimally burdensome for the patients. (c) 2019 Elsevier B.V. All rights reserved.