Although hearing aids have been used for generations to improve communication in the hearing impaired, there is surprisingly little published evidence proving their effectiveness in everyday listening situations, especially for individuals with mild to moderate hearing loss. Fortunately, this lack of evidence is being addressed with some recent longitudinal studies and systematic reviews.
One recent systematic review concluded that hearing aid use in older adults with a mild-to-moderate hearing loss was beneficial in improving communication in everyday situations, general health-related quality of life and improved listening ability with little evidence of harm. This might not seem like a big deal, but for a variety of reasons, systematic evidence-based reviews represent a high bar that a certain treatment is effective. Insurance companies pay attention to them when they are making decisions about reimbursement of treatments, physicians are trained to incorporate their findings in their clinical decision-making process, and savvy patients are starting to look for them online prior to engaging with their doctor.
Hearing aids as a treatment option are no different. Many audiologists attest that a few otolaryngologists remain skeptical on the effectiveness and value of hearing aids, especially for adults considered to be borderline candidates. If you’re looking for some proof that hearing aids are effective for borderline hearing aid candidates – those with mild to high frequency moderate, the internationally recognized source as the highest standard for evidence – Cochrane Review recently published some information you’ll want to share with physicians.
Eight hundred twenty-five adults between 69 and 83 years of age were included in a review, published by the esteemed Cochrane group. After an extensive regimented literature review, Melanie Ferguson, a clinical audiologist and researcher in the UK, and her colleagues found five studies that met the criteria for inclusion in their review. In most cases, a study can only be included in a Cochrane Review if the study design uses randomization and a control group.
The duration of the studies reviewed by the authors ranged from six weeks to six months of hearing aid use. Specifically, the results of this review indicated there is a moderate quality of evidence demonstrating that hearing aids improve listening abilities, as well as improve both hearing specific and general health-related quality of life. Additionally, there was a large effect for real world listening abilities and hearing-specific quality of life improvements from hearing aid use. According to the authors of this review, they found a small beneficial effect on general health-related quality of life associated with hearing aid use. This is a benefit of hearing aids not found in any previous evidence-based review.
As part of their commentary, the authors urged rank and file audiologists to begin consistently measuring outcomes that assess benefit. Finally, the study concluded, “The evidence is compatible with the widespread provision of hearing aids as the first-line clinical management in those who seek help for hearing difficulties.”
Sharing these Findings with Physicians
In general, by virtue of their medical training, physicians will appreciate the power of a meta-analysis using a randomized controlled trial (RCT) in the decision-making process. Making them aware that you are integrating the results of this review into your own clinical decision-making approach could even enhance your standing with many physicians in your practice. Specifically, if there is a physician in your practice that remains skeptical about hearing aid effectiveness in adults with mild to moderate hearing loss, be sure to share the results of this Cochrane Review with them. Simply share with them, “A recent Cochrane Review uncovered five studies with an RCT design, and taken as a whole they demonstrate that hearing aids are an appropriate intervention for motivated patients with mild to high-frequency moderate hearing loss. There is evidence to suggest that hearing aids improve both hearing-related and health-related quality of life for this population.” At your next staff meeting, you can share the entire report with them, if you wish.
Sharing these Findings with Patients
The EDGE hearing aid evaluation process can be an ideal time to mention that very well controlled independent studies indicate hearing aids are effective for motivated patients with mild to moderate hearing loss. There is no need to provide the boring details; simply add a line to your “talk track” when you have the EDGE placemat in front of the patient, and tell them it’s not just you saying this, but well-respected independent researchers who have made the determination after careful analysis that hearing aids really work!
The Importance of Internal Marketing
If marketing is defined as the act of promoting and selling products or services, your ability to read, understand and effectively communicate the findings of research that supports your role in the clinic is an essential part of marketing the expertise and value of audiology to physicians and patients. This is not an easy task. It requires a persistent effort to be both a responsible consumer of research and an assiduous, clear communicator. It is our hope that this short article helps provide you with some relevant material that you can craft into a buzzworthy internal marketing message that touts your audiologic skill and knowledge.
If your practice would like to implement processes to help patient education, contact your regional manager or account manager and get started on initiatives today.
Ferguson MA, Kitterick PT, Chong LY, Edmonson-Jones M, Barker F, Hoare DJ, Hearing aids for mild to moderate hearing loss in adults (Review). Cochrane Database of Systematic Reviews 2017, Issue 9. Art. No.: CD012023.