MedicalResearch.com Interview with:
Larry Humes, PhD, CCC-A
Department of Speech and Hearing Sciences
Indiana University Bloomington
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: About 40% of adults over the age of 60 have significant hearing loss, yet only about 20% of these older Americans seek help and eventually purchase hearing aids. There have been several national calls for improvements in the accessibility and affordability of hearing health care for adults, especially older adults, including a 2015 report by the President’s Council of Advisors in Science and Technology and a 2016 report by the National Academies of Science, Engineering and Medicine. One strategy in common to both of these recent reports is to make hearing aids available directly to the consumer via over-the-counter service delivery.
This study was a double-blind placebo-controlled randomized clinical trial investigating two different service-delivery approaches, best-practices and over-the-counter, and two different purchase prices for the hearing aids ($600/pair, $3600/pair). For the most part, purchase price had no influence on outcomes. Hearing aids delivered via the best-practices service-delivery model were confirmed to be efficacious, but almost identical positive outcomes were obtained via the over-the-counter service-delivery approach.
MedicalResearch.com: What should readers take away from your report?
Response: Hearing aids provide substantial benefits to older adults with hearing loss. This true for both a best-practices approach in which the professional selects and fits the hearing aids and for a consumer-driven over-the-counter approach in which the older adult selects and fits the hearing aids. Alternative approaches to service delivery have the potential to improve the accessibility and affordability of hearing aids for adults with mild-to-moderate hearing loss.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: The “gold standard” for clinical evidence is a systematic review and meta-analysis of SEVERAL clinical trials. This is just the first of what will hopefully be several such studies. This study represents just a starting point, but demonstrates that it is possible to obtain very positive outcomes with a consumer-decides approach to hearing aid selection and fitting. All participants in this study, however, first received a complete hearing evaluation and all received top-quality hearing aids. Some over-the-counter approaches advocate that the consumer also self-assesses the severity of hearing loss or need for assistance. Other approaches also suggest that over-the-counter devices would actually be much simpler devices than the high-quality hearing aids used here. Neither of these potential components of an over-the-counter approach were evaluated here.
MedicalResearch.com: Is there anything else you would like to add?
Response: This research was supported, in part, by a research grant from the National Institute on Deafness and other Communication Disorders. The hearing aids used in this trial were purchased from the manufacturer at cost.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Larry E. Humes, Sara E. Rogers, Tera M. Quigley, Anna K. Main, Dana L. Kinney, Christine Herring. The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial. American Journal of Audiology, 2017; 1 DOI: 10.1044/2017_AJA-16-0111
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