Interventions to improve hearing aid use in adult auditory rehabilitation.

Abstract

Background Hearing loss is very common. People who get hearing loss as adults are often offered a hearing aid(s). However, up to 40% of people fitted with a hearing aid choose not to use it. Study characteristics The evidence is up to date as of November 2013. We found 32 studies involving a total of 2072 people. Most of the people in the studies were aged over 65. There was a mix of new and experienced hearing aid users. Six studies funded by the United States Veterans Association dominate the evidence. The 1018 people in these studies were serving in the military or military veterans. All of the other studies included fewer than 100 people in each study. Results Twenty-seven of the 32 studies looked at ways to help someone to manage their hearing loss and hearing aid(s) better by giving information, practice and experience at listening/communicating or by asking people to practise tasks at home. These are forms of self management support. Most of these studies also changed how the self management support was provided, for example by changing the number of appointment sessions or using telephone or email follow-up. Five studies looked at the effect of just changing how the service was delivered. No studies looked at the effect of using guidelines or standards, computerised medical record systems, community resources or changing the health system. We found no evidence that the interventions helped people to wear their hearing aids for more hours per day over the short, medium or long term. We found no evidence that the interventions encouraged more people to wear their hearing aids, but only two studies measured hearing aid use in this way. We found no evidence of adverse effects of any of the interventions, but it was rare for studies to look for adverse effects. Giving self management support meant that people reported less hearing handicap and improved verbal communication over the short term. When this was combined with changing how the support was delivered people also reported slightly more hearing aid benefit over the long term. Only six studies (287 people) looked at how people were doing after a year or more.