Enhancing hearing loss diagnostics and outcomes in primary care

As an audiologist with over 15 years of experience, I’ve witnessed firsthand the transformative impact of early and accurate hearing loss diagnosis. Hearing health is integral to overall physical and emotional wellbeing, yet it often remains overlooked in primary care settings¹. Here are some insights and strategies for primary care professionals to enhance hearing loss diagnostics and outcomes, drawn from peer-to-peer discussions, clinical observations and available data^{1, #, ^}.

Awareness, education and ease

Despite hearing loss affecting 3.6 million people in Australia², it is frequently undiagnosed. Implementing routine hearing screenings during annual health check-ups is essential for early detection and management of hearing loss. Validated hearing screening questionnaires can be quick and non-intrusive, providing a valuable first step in identifying potential issues. A quick online hearing check that considers patients’ hearing abilities in different environments, including background noise, and includes self-evaluation questions can be conveniently taken in any quiet setting, providing an immediate indication of whether a patient shows any signs of hearing loss. If hearing loss is indicated, it is recommended that the patient is referred to an audiologist for further comprehensive hearing assessment.

Primary care professionals and GPs can help raise awareness about the importance of hearing health and the risks associated with untreated hearing loss¹. According to Audika’s recent sensory survey*, 77% of respondents claim to know someone who is hard of hearing, highlighting the widespread awareness of the issue; however, many patients may not recognise the early symptoms of hearing loss or might attribute them to aging and dismiss them. By discussing the potential impact of hearing loss on cognitive function, mental health and quality of life, primary care professionals can encourage patients to incorporate hearing assessments as part of their annual heath checkups.

A multidisciplinary approach

Hearing loss may be associated with other health issues, such as diabetes³, cardiovascular disease⁴ and cognitive decline⁵. Naturally, it can also intersect with age. Hearing health is often neglected by older patients as our survey* revealed. Almost 7 in 10 (67%) respondents aged 65 or over admit they have not had a hearing test or assessment in the past 12 months, despite almost half (48%) believing they may be experiencing hearing loss^. Adopting a multidisciplinary approach where collaboration between clinicians, primary care providers, otolaryngologists and other specialists can deliver comprehensive patient care. Case studies have shown that integrated care models improve patient outcomes by addressing the multifaceted nature of hearing loss and its comorbidities^1,7.

Preventative strategies can significantly reduce the incidence of hearing loss, and primary care providers can play a pivotal role in advising patients on protecting their hearing. This includes educating patients about the dangers of noise exposure, the importance of using hearing protection in noisy environments and the risks associated with ototoxic medications, such as certain antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs). Regular hearing screenings are strongly recommended as they can help detect early signs of hearing loss, allowing for timely intervention.

Fostering patient-centred communication

Effective communication is key to managing hearing loss. Patients may feel embarrassed or frustrated by their hearing difficulties, which may lead to social isolation and decreased quality of life⁸. The Audika sensory survey found that 59% of respondents believe there is a negative stigma surrounding hearing loss*. For older respondents over 65, the survey also revealed an impact on their feelings toward hearing aids, with 4 in 10 (41%) survey respondents admitting they think there is a negative stigma surrounding hearings aids^. Primary care providers can foster a supportive environment by using patient-centred communication techniques. This involves speaking clearly, facing the patient, reducing background noise and confirming understanding. These practices not only enhance patient engagement but also ensure that hearing concerns are appropriately addressed.

Improving hearing loss prevention, early detection and treatment requires a concerted effort from primary care professionals. By encouraging hearing screenings as part of their annual health checkups, GPs and other healthcare professionals can significantly impact the quality of life for patients with hearing loss.

*Lauren McNee is an Audiologist & National Clinic Coordinator Training Manager at Audika Hearing Clinic. With over 15 years of experience, she is dedicated to improving hearing health, advocates for early intervention and is passionate about enhancing patient care.

^{#The survey was commissioned by Audika Australia. An online survey was scripted and hosted by PureProfile, an independent research services provider. A nationally representative sample of n=1005 Australians aged 18+ were selected via randomisation to participate by the research panel provider PureProfile. Fieldwork was conducted from the 9th of February to the 12th of February 2024.
^All stats pertaining to 65+ featured a sample size of n=219 segmented from the national representative sample.}

<sup>1. Australian Government Department of Health. (2021, October). Roadmap for hearing health. https://www.health.gov.au/sites/default/files/documents/2021/10/roadmap-for-hearing-health.pdf
2. Australian Government Department of Health and Aged Care. (2024, May 14). About ear health. https://www.health.gov.au/topics/ear-health/about
3. Sommer J, Brennan-Jones CG, Eikelboom RH, Hunter M, Davis WA, Atlas MD, Davis TME. A population-based study of the association between dysglycaemia and hearing loss in middle age. Diabet Med. 2017 May;34(5):683-690. doi: 10.1111/dme.13320. Epub 2017 Feb 20. Erratum in: Diabet Med. 2017 Oct;34(10):1488. doi: 10.1111/dme.13511. PMID: 28135010.
4. Baiduc RR, Sun JW, Berry CM, Anderson M, Vance EA. Relationship of cardiovascular disease risk and hearing loss in a clinical population. Sci Rep. 2023 Jan 30;13(1):1642. doi: 10.1038/s41598-023-28599-9. PMID: 36717643; PMCID: PMC9886989.
5. Dawes P, Munro KJ. Hearing Loss and Dementia: Where to From Here? Ear Hear. 2024 May-Jun 01;45(3):529-536. doi: 10.1097/AUD.0000000000001494. Epub 2024 Feb 21. PMID: 38379156; PMCID: PMC11008448.
6. Busselton Population Medical Research Institute. (n.d.). Busselton Health Study. https://bpmri.org.au/research/key-projects-studies/busselton-health-study-2.html
7. Australian Commission on Safety and Quality in Health Care. (2021, April). The Fourth Australian Atlas of Healthcare Variation 2021. https://www.safetyandquality.gov.au/sites/default/files/2021-04/The%20Fourth%20Australian%20Atlas%20of%20Healthcare%20Variation%202021_Full%20publication.pdf
8. Bennett RJ, Saulsman L, Eikelboom RH, Olaithe M. (2021) Coping with hearing loss distress: A qualitative investigation using Leventhal’s self-regulation theory. International Journal of Audiology. Accepted May 2021.</sup>

Image: Supplied.