Hearing-aids: can they be safely prescribed without medical supervision? An analysis of patients referred for hearing-aids

Abstract

A prospective study of 169 patients with hearing loss as their main symptom, referred to the ENT Clinic by General Practitioners, is reported. The study aimed to assess the safety of prescribing hearing aids by Physiological Measurement Technicians from the Audiology Department without medical supervision. The General Practitioners' referral letter and patients' histories were analysed to see if all cases of middle ear disease would be picked up from this information alone. In this study, 31 patients had otoscopic evidence of chronic otitis media, active or inactive, only 14 (45.2%) of whom were identifiable from the referral letters. Of the 8 cases of active inflammatory ear disease, 3 were not mentioned in the referral letter. No asymptomatic cholesteatoma was found in the study population. At present all patients are reviewed by ENT medical staff prior to prescription of a hearing-aid; we feel this should continue.

Direct hearing aid referrals: a prospective study

“…Previous studies of this subject showed that between 35 and 50% of patients referred for a hearing aid would require cross referral for an ENT opinion when applying criteria very similar to the one we used in our study. [2][3][4][5][6] Our results appeared to be much better with only 10% requiring cross referral. We attribute this to the design of our study in which every referring GP was fully informed of the function of the direct referral system and was provided a standard referral form to help with the selection of patients suitable for the scheme.…”

A prospective evaluation of direct referral to audiology departments for hearing aids

“…Subsequently, in the second report, stimulated by the lack of progress, it was suggested that hearing aids could be provided in health centres by community dispensers supervised by general practitioners (GPs). Following this report, several papers were published, some supporting maintenance of the status quo (Bellini et al, 1989;Harries et al, 1989;Watson and Crowther, 1989;Campbell and Nigam, 1991), some the community provision of hearing aids (Prinsley et al, 1989), and some direct referral to technicians (Hawthorne et al, 1991). Those in favour of the status quo based their conclusion on either a prospective review of patients referred to their department (Bellini et al, 1989;Harries et al, 1989;Watson and Crowther, 1989) or a retrospective case sheet review from which they reported the prevalence of pathology requiring management by an otolaryngologist (Campbell and Nigam, 1991).…”