Tele-intervention for adults with tinnitus in Ghana, a low- and middle-income country : a feasibility study

Abstract

BACKGROUND : Tinnitus may be associated with anxiety and depression which can affect quality of life. In low- and middle-income countries like Ghana, a shortage of specialized clinicians suggests online interventions could alleviate clinician caseloads, but the feasibility of online intervention is yet to be explored. This study assessed the feasibility of providing tele-intervention in the form of online educational counselling (OEC) for adults with tinnitus in Ghana. METHODS : This single-arm trial included 53 Ghanaian adults (female = 21, median age = 34 years) with significant tinnitus severity, internet access, email, and English literacy. Standardized questionnaires were used to assess tinnitus severity, anxiety, and depression levels pre- and post-intervention. Online educational counselling was provided using a free downloadable tinnitus self-help resource over three weeks. Pre- and post-intervention scores were compared and participant perceptions were recorded. RESULTS : Significant reductions in tinnitus severity, anxiety, and depression levels occurred post-intervention. Over half (54.7%) of the participants reported significant reductions in tinnitus severity post-intervention. Bivariate comparisons showed the reduction was associated with baseline tinnitus severity and depression level but not with sex (p = 0.400), hearing status (p = 0.530), or anxiety levels (p = 0.058). Participants demonstrated high adherence (93%) and provided positive feedback on the tele-intervention. CONCLUSION : Online educational counselling for tinnitus is feasible in Ghana based on adherence and feedback. These findings support integrating OEC into tinnitus care in low-resource settings as an initial, scalable option or within a multi-faceted program.