Norway's tinnitus anguish compounded by GPs' lack of knowledge and specialists considering the subject "not interesting enough"



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Norway's tinnitus sufferers are being failed by poor treatment provision despite major studies recommending improvements, says a study published by one of Europe's largest independent health research organisations.

SINTEF - Stiftelsen for industriell og teknisk forskning "The Foundation for Industrial and Technical Research" - has highlighted failings in tinnitus treatment that include misinformation, lack of knowledge among GPs, major variations in medical attention, lack of provision of differentiated treatment regimes, and the rejection by specialist health service professionals of tinnitus as "not interesting enough".

The focus of the report, which was commissioned by the Norwegian Association for the Hard of Hearing, was the extent to which previous medical recommendations on the treatment of tinnitus are being followed up by the Norwegian public authorities and health trusts.

Unnecessary suffering

These previous recommendations were made as long ago as 2003 and 2005 in studies commissioned by the Norwegian Directorate of Health and the then Ministry of Health, respectively. Both concluded that changes were needed. However, the recent study has revealed that the situation in the patient population hasn’t changed in the last twenty years, despite the recommendations.

One in five Norwegians has tinnitus. The main conclusion reached by the SINTEF researchers is that many of these are suffering unnecessarily.

“The report shows that when it comes to tinnitus, Norway fails to adhere to the principle of offering treatment at the lowest level of effective care, which is normally the case elsewhere in our health system”, says Tron Vedel Tronstad, a SINTEF audiologist and research scientist and one of the authors of the report. “This is a cause for concern, especially when we know that as many as one in five Norwegians are suffering from the condition”, he says.

Treatment provision also varies according to where in the country you live. Moreover, the researchers have concluded that the patient population is not offered differentiated treatment regimes tailored to the severity of the condition.

"Our lack of diagnostic expertise means that patients who should have been referred to, and examined by, a specialist are sent home by their GPs", says Tronstad. "At the same time, many other sufferers are referred to specialists and sent on extended treatment journeys that are totally unnecessary and expensive to the taxpayer."

GPs lacking knowledge of tinnitus

The SINTEF researchers underline that general practitioners - those working at the first line of medical attention - need to increase their learning about this condition.

Between 80 and 90 percent of GPs interviewed by the SINTEF researchers responded that they had a moderate to acute need for more knowledge about the treatment of tinnitus sufferers. As many as 40% had seen patients with tinnitus complaints during their last five days at work.

e-learning possibilities exist

In their report, the researchers point out that e-learning courses containing information about tinnitus, combined with other basic initiatives, ought to be introduced. Such initiatives should be aimed at both GPs and the patient population.

"In fact, initiatives of this type already exist, but they are not well known so very few people take advantage of them”, says Tronstad.

One of the findings made by the SINTEF researchers revealed that skills development in tinnitus is largely rejected by professionals in specialist health care services because the subject is not regarded as interesting enough.

However, these services also have a ‘duty of care’ – in other words, an obligation to offer treatment. The researchers have also revealed that there is no financial incentive for hospitals and clinics to offer thorough diagnostics and effective medical treatments for tinnitus.

The conclusions in the report are based on a comprehensive analysis of documents, combined with qualitative interviews with ear, nose and throat specialists, audiographers, coaches of people with hearing loss, as well as tinnitus sufferers themselves.

Source: SINTEF