A new paper that reviews the state of research for adults with hearing loss, written by two University of Michigan Department of Family Medicine faculty members in conjunction with a physician from Johns Hopkins Hospital, has been published in the Disability and Health Journal.
The paper was authored by Michael M. McKee, M.D., M.P.H., Frank Lin, M.D., M.P.H., and Philip Zazove, M.D. Dr. McKee is an assistant professor in the Department of Family Medicine and is a family physician with clinical and research expertise in disability health. Zazove is the George A. Dean M.D. Chair of Family Medicine and a clinical and research expert in health services for deaf and hard of hearing individuals. Dr. Lin is associate professor of Otolaryngology-Head and Neck Surgery at Johns Hopkins Hospital in Baltimore. The paper will appear in the October 2018 issue of the journal.
Hearing loss affects more than 15 percent of Americans and has a profound but often overlooked impact on adults, particularly seniors. Too often, medical professionals treat hearing loss as a lower priority condition or remain unaware of the impacts that hearing loss can have on the social, cognitive, and physical health of those suffering from hearing loss.
The Disability and Health Journal review synthesizes current research and shows that untreated hearing loss hurts the ability of older adults to carry out everyday tasks, reduces their quality of life, and is linked to social isolation, lower income, reduced cognitive function and poorer physical and psychological health.
Conversely, treating individuals with severe hearing loss may have benefits that reverberate across the health care system. A recent study, led by fellow disability health researcher in the department of family medicine Elham Mahmoudi, Ph.D., M.B.A., M.S., found that adults with hearing aids have lower chances of being hospitalized or visiting an emergency room than adults with hearing loss who do not have a hearing aid. Mahmoudi expounds in a recent editorial in The Hearing Journal.
On the new review, McKee notes “My co-authors and I have done research and clinical care with this population. We are able to directly see the impacts that hearing loss has on one’s health and we are committed to reducing existing health inequities.”
“The medical community unfortunately either has hearing loss as a lower health priority or they remain unaware of the impacts that hearing loss can have on psychosocial, cognitive, and physical health,” he said.
Results and additional research
The review points out several gaps in the medical community’s knowledge of hearing loss and proposes strategies to deal with them at the patient, clinician and system levels. For example, studies have found that some over-the-counter pain relievers have been responsible for hearing loss in a small number of adults, but those types of pain relievers are so common and so widely used that there are significant hearing loss implications. Yet, there are few human-based studies available. That lack of research means it is not possible for physicians to identify populations at the highest risk for potential hearing loss caused by certain medications or to guide physicians when making choices about appropriate dosage level and duration of exposure.
Physicians also have known that older adults with hearing loss are more likely to be hospitalized than their hearing peers with healthy hearing even after adjusting for comorbidities. But the literature review showed that individuals with even mild hearing loss reported a 16-percent greater risk of hospitalization than individuals with no hearing loss. The risk was 21-percent higher for those with moderate hearing loss. When looking at hearing aid usage, the studies were clear that adults using a hearing aid had significantly lower probability of hospital-based visits (20 percent versus 22 percent) but higher overall outpatient visits (96 percent versus 92 percent).
Although the studies provided data for the questions asked, the review shows those studies rarely asked for the “whys” behind the answers. This new paper points out that for a deeper understanding, researchers need to perform longitudinal and cost effective health care-based studies. Those additional studies will help demonstrate the potential benefits of hearing aids on the physical and psychological health of adults with hearing loss.
In general, the physicians identified four broad examples to improve research that they believe could lead to better outcomes:
- Improve ways to measure and record hearing loss in research and clinical records.
- Develop new ways to effectively train clinicians to better manage hearing loss and their associated health conditions.
- Determine the best ways to include and disseminate hearing aid/disruptive assistive technology to individuals in need. (Disruptive assistive technology is new devices that “disrupt” the marketplace. Hearing aids can only be purchased currently through licensed dealers. New technologies but new technologies are disrupting the market place. One such technology is the Fennex augmented hearing app that turns an iPhone connected to wireless Airpods into a customizable hearing aid.)
- Learn ways to better understand the mechanisms of how hearing loss, including genes that cause hearing loss, can impact patient health directly and indirectly.
The paper also admits that many health institutions could do a better job of making information accessible and calls for the creation of quality-based programs that demonstrate best practices on how to communicate and care for adults with hearing loss. Once those programs are established, self-assessment can help find new ways to improve health care utilization and satisfaction for the population.
“I am hopeful that the paper will increase awareness on the importance of addressing hearing loss in our patient population and in our research,” McKee said. “We also need more funding for hearing loss research that looks closely at their clinical correlates and health care management.”
Read about how the University of Michigan Department of Family Medicine is addressing the unique health care needs of D/deaf individuals at the Deaf Health Clinic. Browse the latest disability health research from the Department of Family Medicine.
Article citation: Mckee MM, Lin FR, Zazove P. State of research and program development for adults with hearing loss. Disability and Health Journal. 2018 October (in-press). doi:10.1016/j.dhjo.2018.07.010.