Hearing Aid Use and Adherence to Treatment in a Publicly-Funded Health Service from the City of São Paulo, Brazil

Abstract

Introduction Periodic follow-up appointments are important to ensure long-term effectiveness of rehabilitation with hearing aids. However, not all users are able to maintain adherence to recommendations prescribed during the fitting process and some do not attend those appointments, which compromises the effectiveness of treatment. Objective Compare hearing aid use after 1 year between subjects who did not attend a follow-up evaluation appointment at a publicly-funded health service (nonattenders) and those who attended the appointment (attenders). Reasons for nonuse of hearing aids and unscheduled appointments were also analyzed. Methods Prospective observational cross-sectional study. Nonattenders and attenders in a follow-up evaluation appointment were interviewed by telephone about hearing aid use, reasons for nonuse, and unscheduled appointments. Results The nonattenders group consisted of 108 subjects and the attenders group had 200 subjects; in both groups, most users kept bilateral use but the nonuse rate was higher in nonattenders. The main reason for nonuse of hearing aids among nonattenders was health problems; fitting problems was the main reason for nonuse in the attenders group. Health problems and issues like unavailable companion and transportation difficulties were the reasons for unscheduled follow-up appointments. Conclusion Nonattenders had a greater nonuse rate and were more likely to abandon hearing aid use. Measures to increase hearing aid use and adherence to prescribed recommendations are also necessary to ensure long-term effectiveness of rehabilitation with hearing aids.

Factors Impacting the Use or Rejection of Hearing Aids—A Systematic Review and Meta-Analysis

“…Adherence tends to be lower in patients over 80 years old who use bilateral devices [ 12 ]. A long time of use of the device is associated with more daily use [ 26 , 30 , 31 , 32 , 35 ]. Studies have shown that a longer duration of device use is associated with increased daily usage [ 26 , 30 , 31 , 32 , 35 ].…”

“…A long time of use of the device is associated with more daily use [ 26 , 30 , 31 , 32 , 35 ]. Studies have shown that a longer duration of device use is associated with increased daily usage [ 26 , 30 , 31 , 32 , 35 ]. Maul et al support these findings and assert that approximately half of the patients prescribed hearing aids do not utilize them.…”

“…Studies have shown that better adherence is associated with more frequent medical consultations and closer monitoring by healthcare professionals. Providing detailed information and regular monitoring increases patients’ motivation to seek information, try the devices, and ultimately use them [ 26 , 28 , 30 , 31 , 32 , 35 ]. Abdellaoui et al found that one-third of patients with age-related hearing loss did not complete the follow-up of their hearing aid prescription with ENT services, citing reasons such as economic constraints or lack of motivation.…”

“… Forest plot showing prevalence in group A [ 10 , 12 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. …”

“… Assessment of the methodological quality of each study applying the ROBINS-I scale [ 10 , 12 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. …”