"REAL-WORLD PRESCRIBING PATTERNS AND CLINICAL OUTCOMES OF ANTI-TINNITUS MEDICATIONS: A POPULATION-BASED COHORT STUDY"
Main Article Content
Keywords
Tinnitus, Anti-tinnitus medications, Prescribing patterns, Clinical outcomes, Caroverine, Betahistine, Population-based cohort
Abstract
Background: Tinnitus, characterized by the perception of sound in the absence of an external stimulus, remains a challenging condition with limited therapeutic options and variable patient outcomes. Despite the widespread use of anti-tinnitus medications, there is a paucity of real-world evidence on prescribing patterns and their association with clinical outcomes in population-based cohorts.
Objectives: To evaluate real-world prescribing patterns of anti-tinnitus medications and to assess their clinical outcomes in a population-based cohort of patients with tinnitus.
Methods: A retrospective cohort study was conducted among 165 patients diagnosed with tinnitus between January 2022 and December 2024. Data were extracted from electronic medical records and prescription databases. Baseline demographic and clinical characteristics, medication classes (including Caroverine, Betahistine, benzodiazepines, antidepressants, anticonvulsants, and nutraceuticals), treatment duration, and adherence patterns were analyzed. Outcomes were assessed in terms of symptom reduction measured by the Tinnitus Handicap Inventory (THI) scores, patient-reported improvement, and adverse drug reactions (ADRs). Statistical analysis included descriptive statistics, chi-square tests for categorical comparisons, and multivariable logistic regression to identify predictors of treatment response.
Results: Of 165 patients (mean age 48.6 ± 12.4 years; 56% male), Caroverine was the most commonly prescribed agent (32.72%), followed by Betahistine (30.30%) antidepressants (214.54%), benzodiazepines (10.30%), anticonvulsants (06.66%) and nutraceuticals (05.45%). Monotherapy was more frequent (71%) compared to combination therapy (29%). At 6-month follow-up, 54% of patients reported clinically significant improvement in THI scores. Caroverine users showed good response followed by Betahistine users compared to other drug classes (p<0.05). Adherence was moderate (mean medication possession ratio 0.68), and 11% discontinued treatment due to adverse events, most frequently headache, dryness of mouth with Caroverine followed by sedation and gastrointestinal disturbances with other anti tinnitus medication. Logistic regression revealed younger age (<50 years), shorter duration of tinnitus (<2 years), and Caroverine followed by Betahistine prescription as independent predictors of favourable outcome.
Conclusions: Real-world prescribing patterns for tinnitus management are dominated by Caroverine followed by Betahistine and antidepressants, with moderate adherence and variable clinical outcomes. Betahistine was associated with better symptom improvement, particularly in younger patients and those with shorter symptom duration. These findings underscore the need for individualized prescribing strategies and further randomized studies to optimize tinnitus management.
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Dr. Revalle Shravan Kumar
Associate professor of ENT, Department of ENT, Prathima institute of medical sciences, Hanamkonda, Telangana
Dr Sakinala Sunil
Associate professor of ENT, Department of ENT, Prathima institute of medical sciences, Hanamkonda, Telangana
Dr. M. Vamshi krishna
Associate professor of ENT, Department of ENT, Government medical college, Department of ENT, Mulugu, Telangana, formerly Associate Professor of ENT, Pratima relief institute of medical sciences, Hanamkonda.