Question
What are the primary factors—beyond the objective degree of hearing loss—that influence an individual's decision to adopt hearing aid technology, and how can clinicians leverage these insights in their patient consultations?
Answer
The objective degree of hearing loss, as shown on a patient's audiogram, does not correlate with adoption as fast as one might hope. The reality, according to a 2009 study by Kotchkin, is that adoption of hearing aids remains low in spite of the degree of hearing loss that a patient is dealing with, meaning objective hearing loss does not predict hearing aid adoption. The single biggest predictor is actually self perceived hearing ability. Researchers in a study by Katherine Palmer found that patients' ratings of their own hearing on a scale of 1 to 10 was the most consistent influence. For instance, 0% of individuals who rated their hearing ability as a 9 or 10 out of 10 pursued hearing aids, whereas 82% of people who rated their hearing ability as a 3, 4, or 5 out of 10 went ahead and took that leap. This finding was true no matter what their actual audiogram looked like, highlighting that how people feel about their own hearing really makes a huge difference in their readiness to adopt hearing aids.
Social relationships and emotional comfort also play a significant role in the patient's decision-making process. Humans are a pack species, and significant others inform decision making, influencing the patient's experience and their motivation to pursue and make a change. For patients with a more mild hearing loss, there was a 96% higher adoption rate when a significant other was involved, proving that the impact of social support might be greater in patients who may be "on the fence." Clinician comfort in addressing a patient's emotions is equally important, as patients that were comfortable discussing their feelings with their provider were more likely to adopt hearing aids. The lack of emotional engagement was found to contribute to low hearing aid uptake, even when the clinician recommended hearing aids to the patient.
Finally, decision-making can be influenced by cognitive load and the time of day. A study by Gurjit Singh and Stephan Launer that analyzed over 24,000 patient records found that hearing aid adoption dropped significantly at 12pm and 4pm. Patients who were on the fence were less likely to adopt hearing aids at these times. This suggests that avoiding noon and late afternoon time slots for patients when they might have some decision fatigue and may be less likely to accept a new solution into their life could be a clinical strategy to improve adoption rates. Another recent factor is the approach to consultation pricing, as when services were unbundled and charging for hearing aid consults was introduced, a higher percentage of patients did adopt hearing aids.
To explore these concepts in greater depth and earn continuing education credit, check out the course, Factors Associated with Hearing Aid Adoption.
