Abstract: Hearing loss is the third most common chronic health condition, yet most affected individuals do not seek the care of an audiologist. Many reasons for underutilization have been proposed, including the role of primary care. Recent studies suggest most primary care providers do not ask about hearing routinely, may not believe hearing can be improved, and demonstrate significantly lower referral patterns for hearing testing than evaluation for other common health screenings. This presentation will include the results of a recent hearing screening study, review of the literature, and discussion of strategies for elevating hearing health in primary care practices.
Summary: By 2050 2.5 billion people worldwide will have hearing loss; > 700 million people access hearing care with an annual global cost of untreated hearing loss of >$750 billion. Hearing loss has been clinically associated with social isolation, depression, cognitive impairment (leading modifiable risk factor for Alzheimer’s dementia in middle age) and falls. Increasing the number of individuals having hearing tests and using hearing aids is a US Office of Disease Prevention Healthy People 2030 goal. Passage of the Over the Counter (OTC) Hearing Aid Act in 2017 and FDA OTC Hearing Aid regulations in 2022 promises more affordable hearing aid solutions, but the path to elevate the importance of hearing loss as an impactful health condition has not been well-addressed.
Despite the clinical and financial impact of HL, potentially accessible solutions, and call to action, 75% of hearing loss remains under-diagnosed and under-treated. Reasons for this disconnect include lack of awareness amongst clinicians. Approximately 50% of primary care physicians erroneously believe nothing can be done about hearing loss and only a fraction ask about it unless prompted. Lack of awareness regarding clinical, financial and societal impact including basic communication with health systems, implicit bias and lack of awareness regarding affordable hearing loss solutions may be other contributors. Finally, the US Preventative Services Taskforce recently determined evidence for adult hearing screening is inconclusive and more research is needed.
Recent studies regarding primary care knowledge, attitudes, and behaviors regarding hearing loss reveal that a majority of providers don’t routinely discuss hearing loss, recommend hearing testing, or believe that hearing loss can be prevented or improved.
This learning module will address the current challenges inherent in elevating hearing loss to a level of importance in the minds of consumers and primary care providers. Current literature will be reviewed and results of a recent tablet-based hearing screening study involving nearly 2000 patients will be presented. The presentation will highlight how collaborative, standardized assessment and management of hearing loss equates to better outcomes for patients by focusing on a preventative wellness approach and escalation of importance of hearing as a key aspect of health.
Learning Objectives:
Describe the value of incorporating hearing screening in primary care practices.
Discuss the reasons that referral to audiology practices from primary care may be limited.
Discuss the reasons that adult hearing screening has not been mandated but may be valuable.