Preeti Pandey, Hansapani Rodrigo, Megan Kruger, Eldre Beukes, De Wet Swanepoel, Anu Sharma, Gerhard Andersson, Vinaya Manchaiah
Tinnitus severity is associated with multidimensional reductions in HRQoL, particularly in functional activity and emotional health. The identification of a high-burden profile characterized by anxiety, depression, sleep disturbance, and activity limitation highlights the need for integrated, biopsychosocial approaches to tinnitus management.
PURPOSE: The study aimed to characterize the multidimensional burden of tinnitus on health-related quality of life (HRQoL) using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) moving beyond symptom severity alone.
METHOD: A cross-sectional analysis was conducted using baseline data (N = 428, Mage = 54.9 years, 51.9% female) from several clinical trials examining the efficacy of internet-based cognitive behavioral therapy for tinnitus. Data were collected using a series of online questionnaires including demographic, audiological, and clinical variables. HRQoL was assessed using the EQ-5D-5L profile dimensions.
RESULTS: Participants primarily reported no problems with mobility (76.6%), self-care (92.5%), and usual activities (65.2%); however, pain/discomfort (33.4%) and anxiety/depression (40.2%) were the most affected EQ-5D-5L dimensions at baseline. Higher tinnitus severity was consistently associated with worse outcomes across all dimensions (p < .05). A 10-point increase in Tinnitus Functional Index (TFI) scores was associated with 53% and 51% higher odds of worse usual activities and anxiety/depression, respectively. Participants reporting a fully healthy EQ-5D-5L profile had substantially lower tinnitus severity compared with those with any reported problems (mean TFI: 39.0 vs. 55.3, d = 0.78). Cluster analyses identified a smaller subgroup with markedly poorer multidimensional health, characterized by higher tinnitus severity and greater psychological and sleep-related distress, with no significant differences in demographic or audiological characteristics between profiles.
CONCLUSIONS: Tinnitus severity is associated with multidimensional reductions in HRQoL, particularly in functional activity and emotional health. The identification of a high-burden profile characterized by anxiety, depression, sleep disturbance, and activity limitation highlights the need for integrated, biopsychosocial approaches to tinnitus management.
SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.33307416.