by Brian Taylor, AuD, Editor-at-Large
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.