Background and Objectives

Half of older persons experience serious hearing loss, yet it remains under-assessed in primary care clinics. Providers note time constraints as barriers and patients often minimize or deny their hearing loss. We tested the effectiveness of a simple hearing screen in primary care settings and whether including a brochure describing hearing loss, its consequences, and treatment would increase referrals for formal audiometric assessments.

Research Design and Methods

We designed a longitudinal effectiveness study assessing three interventions: Screening alone; Screening plus a brochure handed to the person testing positive; and Screening plus the brochure with a brief review. Screening was accomplished by intake personnel. Results of a positive screen were given to the primary care practitioner The approach was designed to enable its use across a range of primary care settings. Follow-ups occurred at 4 and 8 months.

Results

111 older adults attending 7 primary care clinics screened positive for having possible hearing loss by intake personnel. Forty-six received the educational brochure. Physicians discussed test results with two-thirds yet recommended further testing for only half of the participants. Physician recommendations were strongly motivating (OR = 9.12, 95% CI = 3.54 – 23.52) and those receiving the brochure were still more likely to seek further testing (OR = 2.61, 95% CI = 1.07-6.36) even when physician recommendations were controlled. Additionally, when combined, the two options were strongly motivating: all participants receiving both a referral and a brochure sought further testing.

Discussion and Implications

A simple screen and educational brochure on hearing loss improved follow-up for a formal hearing evaluation which may improve hearing healthcare and minimize negative outcomes. The study also identified barriers to implementation, including how to motivate practitioners and assist intake personnel integrate hearing screening into their routine intake procedures, supporting further research.

© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.