Hearing Aids
Clarissa Chan, PharmD
According to a randomized clinical trial published April 2023 in JAMA Otolaryngology–Head & Neck Surgery, self-fitted OTC hearing aids demonstrated similar clinical outcomes to audiologist-fitted hearing aids using best practices in patients with mild-to-moderate hearing loss within a 6-week period.
FDA-approved OTC hearing aids became available for purchase in October 2022 at pharmacies. The arrival of these items on pharmacy shelves is an opportunity for pharmacists and audiologists to collaborate. In fact, a recent article from the May/June 2023 issue of Audiology Today suggests models for collaborative working relationships between audiologists and pharmacists to help improve access and affordability for patients with hearing care needs.
Collaborate to improve access
“Pharmacists and audiologists can collaborate in many different ways,” said Lucas Berenbrok, PharmD, one of the authors of the Audiology Today article and an associate professor at the University of Pittsburgh School of Pharmacy. “Pharmacists can refer to local audiologists when patients are not candidates for OTC hearing aids, when they require refined customization, and when their needs are not met by OTC devices.”
He added that audiologists can refer patients to pharmacists for the purchase of OTC hearing aids, hearing aid batteries, hearing protection, and self-treatment of earwax buildup.
Since self-fitted and audiologist-fitted hearing aids show clinically similar results, it is up to pharmacists and audiologists to collaborate and merge expertise to increase access to hearing care. According to Berenbrok, it is important for pharmacists to know when and how to make referrals to audiologists for more complex cases.
“We will need to trust that pharmacists can be trained to recognize red-flag conditions excluding patients from OTC hearing aid use and make referrals in the interest of supporting patient outcomes,” wrote the authors in Audiology Today.
Often this might mean overcoming interprofessional collaboration obstacles to patient care, including turf boundary concerns, communication breakdown, lack of trust in provider competence, perceived power differential, and distance from practice sites.
Pharmacists can take the initiative to connect with local audiologists by searching on the American Academy of Audiology’s Find an Audiologist directory. Reaching out to audiology colleagues with questions on when and how to refer patients to their offices will open lines of communication to benefit patient care.
“Collaborative working relationships between pharmacists and audiologists are essential for the success of OTC hearing aids in America,” said Berenbrok.
How pharmacists can advise patients
“There are two categories of hearing aids available,” said Karina De Sousa, PhD, project coordinator in the Department of Speech-Language Pathology and Audiology at the University of Pretoria in South Africa.
OTC devices can be self-fitted or preset, both of which are regulated by FDA. Pharmacists may view self-fitting as a feature that some consumers may prefer over preset, said Berenbrok.
Pharmacists should look for the “self-fitting” label on hearing aid packaging and confirm that they are FDA compliant to weed out bad products. A guide to purchasing OTC hearing aids can be found at apha.us/HearingAids.
A defining characteristic of FDA-registered OTC hearing aids is the availability of patient adjustability features that do not need intervention from licensed hearing aid professionals.
Prescription hearing aids require a licensed hearing aid professional to perform needed services, like managing the customization, features, and fine-tuning of the hearing aid, according to Elaine Mormer, PhD, who coauthored the Audiology Today article with Berenbrok and is professor and audiologist at the University of Pittsburgh.
“Help patients decide if they are potential candidates. Patients will not qualify for an OTC hearing aid if they have a history of complex ear pathologies like recurrent ear infections, requiring more specialized care by an audiologist. If hearing loss is too severe, patients may also not benefit from an OTC option,” said De Sousa. ■
Questions pharmacists should consider when helping patients with OTC hearing aids:
- Is this a quality brand?
- What are the features it offers that are important for my patient’s needs?
- How do I fit the device? Does it provide a level of customer support that could help my patient, if needed?
- What is the warranty and return policy?
- What can I do if the device breaks?
- What is the cost and how long is it expected to last?
- Will this be appropriate for my patient’s type and degree of hearing loss?
- What’s the next step if this option does not work for my patient?