Regional Healthcare System Implements Effective Hearing Screening Program

by Brian Taylor, AuD, Editor-at-Large

Brian Taylor, Hearing Health Matters
Brian Taylor, AuD

Although the esteemed US Preventative Services Task Force (USPSTF), using a rigorous science-based criteria, recently concluded there was insufficient evidence to support physicians screen for hearing loss in all individuals aged 50 years and older, it has not stopped some healthcare systems from implementing effective adult hearing screening programs. 

For the second time in eight years the USPSTF acknowledged there are several adverse outcomes associated with untreated hearing loss, but they, again, came to the conclusion that better studies were needed to evaluate the effect of hearing screening on the health-related outcomes associated with healthy aging adults.

Yet, this has not stopped University of Michigan medical staff from implementing the Early Auditory Referral-Primary Care program, results of which were published in a recent issue of Annals of Family Medicine

 

Screening Adults for Hearing Loss

 

Using a single question, “Do you have difficulty with your hearing?” embedded in their electronic medical records systems and posed to individuals aged 55 years and older, ten regional family medicine practices in Michigan participated in a study that evaluated the effectiveness of a universal adult hearing screening program. 

For consenting individuals who believed they had hearing difficulty, the abbreviated, 10-question version of the Hearing Handicap Inventory (HHI) was completed. Of the 5,883 individuals completing the HHI, 25.2% had HHI scores of 10 or greater, which is suggestive of hearing loss. This group was more likely to be referred to an audiologist for testing. Of the 1,660 individuals referred for hearing testing 93.3% deemed by the audiologist to be appropriately referred and 58.7% were considered to be hearing aid candidates. Additionally, 71.5% of patients contacted believed they were appropriately referred to the audiologist. 

Overall, the study demonstrated a fivefold increase in referrals from family medicine to audiology when a one-question prompt and the HHI questionnaire are part of the hearing screening process.

Although 72% of individuals with a “failure” on the HHI were not referred to audiology for a variety of reasons, this study provides solid evidence that a typical family medicine practice can accurately identify and refer adults suspected of hearing loss of early onset for proper follow-up care from audiologists.

The study serves as a template for large healthcare systems with Family Practice and Audiology departments on how they can work together to better meet the needs of adults with hearing loss. 

Citation:

Philip ZazoveMelissa A. PlegueMichael M. McKeeMelissa DeJonckheerePaul R. KilenyLauren S. SchleicherLee A. GreenAnanda SenMary E. RapaiElie Mulhem.

1 Comment

  1. I think this study (inadvertently) highlights USPSTF’s recommendations very nicely. If my interpretation and calculations are correct:
    557 (of the 14,411 screened) were selected for a follow-up phone call;
    392 recalled the discussion about the results of the hearing screen;
    347 recalled being referred for further testing;
    314 accepted the referral;
    267 made an appointment for further testing;
    219 kept the appointment;
    131 were given specific recommendations at the appointment;
    92 planned to follow the recommendations;
    46 planned to purchase hearing aids if that was the recommendation;
    ??? purchased hearing aids (probably less than 25% given similar studies).

    Per USPSTF’s conclusion, these 557 did not specifically request a hearing test at their primary care visit and the fact that they were screened ended up being of questionable value in terms of improving their health outcomes. 

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