PP905 - Physician Perspectives on the Importance of and Barriers to Hearing Health Care for Older Adult Patients with Hearing Loss

Abstract:
This study explored the perceived importance of and barriers to integrating hearing healthcare in medical practice among physicians. A cross-sectional survey revealed that while most physicians recognized the link between hearing and overall health, discussions on hearing were infrequent. Common barriers include limited resources, time constraints, patient knowledge gaps, and stigma. These findings underscore the need for enhanced education for both patients and physicians to improve access and utilization of hearing healthcare services, highlighting opportunities for system-level improvements in medicine.

Summary:
Introduction
The primary care physician is usually the first contact for a person who is having concerns about their hearing. 63% of patients report relying on their primary care physician as the key individual for seeking hearing healthcare services (American Academy of Audiology, 1998). However, research has shown that hearing screenings are often not included in primary care settings (Johnson et al., 2008; Kochkin, 1994; Sullivan, 1992). Various barriers to the use of hearing healthcare exist, such as access to audiologic resources, high cost, and a complicated treatment pathway (Palmer & Zitelli, 2024). Aside from external factors, limited patient and physician awareness and understanding of hearing healthcare contribute to the utilization of services. According to survey studies, 84% of people with hearing loss misidentified their hearing status (Angara et al., 2021), and only 57% of primary healthcare providers were aware of the standard definition for normal hearing (Sydlowski et al., 2022). The purpose of this study was to explore the perceived importance of and barriers to incorporating hearing healthcare into medical practice among physicians who see adult patients.

Methods
A cross-sectional survey was administered to physicians in the United States and internationally via email and word-of mouth. Questions included:
1) “What are the top three barriers you face when integrating hearing health care into your practice? Please list in order of significance.”
2) “On a scale of 1 (not important) to 5 (extremely important), how important do you consider hearing health in the overall health care of older adults?”
3) “How frequently do you discuss hearing health with your older patients?”
4) “If you could change one thing about the current hearing healthcare approach or system, what would it be?”

The survey was developed in Qualtrics and took 5 to 10 minutes to complete. This study was approved by the California State University, Sacramento Institutional Review Board (#23-24-14).

Results
Data collection is in progress but will be completed by February. Preliminary data are from 25 physician respondents. About half of the participants were from the United States of America. Various areas within medicine (e.g., primary care, specialties) were represented. Though most participants agreed that hearing and overall health are interconnected, there were reports of only occasionally or rarely discussing it with patients. Referring patients to an audiologist was also described by about one-quarter of the participants as difficult. Open-ended responses were coded, revealing themes including but not limited to lack of resources, patient lack of knowledge of the importance of hearing healthcare, cost, time constraints, and stigma.

Conclusions
The results show that a lack of resources and time makes it difficult for physicians to adequately address hearing health. Further, a combination of insufficient patient and physician knowledge contributes to the issue. Thus, increased patient and physician education on hearing healthcare is needed to increase access to and utilization of hearing healthcare services.