An Innovative Approach for Increasing Access to Over-the-Counter Hearing Aids in Rural Communities of Alabama

Abstract

Adults living in rural communities of Alabama have limited or no access to hearing healthcare for a variety of reasons. Hearing loss can result in decreased social contact, potentially leading to loneliness, and it has been associated with depression and cognitive decline. To improve access to hearing healthcare, the FDA released its Final Rule in 2022 stating that adults with perceived mild-to-moderate hearing loss can purchase over-the-counter hearing aids (OTC HAs) on their own without clearance from a physician or through the care of an audiologist. Current research suggests, however, that adults benefit from professional support when purchasing and setting their OTC HAs. Understanding how much support is needed and how to best provide the support will be necessary for successful OTC HA use. Considering that these devices can now be purchased at pharmacies, one model in rural areas could involve the pharmacy technician who could assist and support those with hearing loss in community pharmacies. This article outlines a pharmacy technician educational training program that will incorporate didactic, interactional, and experiential learning components to promote the use of OTC HAs. The outcomes from this project will provide the foundation for the development and implementation of one model for improving access to hearing healthcare in rural communities.

Keywords

community pharmacy service - continuing pharmacy education - hearing loss - rural health services

Publikationsverlauf

Artikel online veröffentlicht:
21. März 2025

• References

• 1 Wharton TC, Church WT. Consideration of one area of persistent poverty in the United States. Soc Dev Issues 2009; 31 (01) 27-38
• 2 United States Department of Agriculture. Persistent poverty counties and census tracts, 2015–19. Accessed March 3, 2025 at: https://www.ers.usda.gov/data-products/chart-gallery/gallery/chart-detail/?chartId=105109 . Published 2022
• 3 Hay-McCutcheon MJ, Yuk MC, Yang X. Accessibility to hearing healthcare in rural and urban populations of Alabama: perspectives and a preliminary roadmap for addressing inequalities. J Community Health 2021; 46 (04) 719-727
• 4 Hay-McCutcheon MJ, Reed PE, Cheimariou S. Positive social interaction and hearing loss in older adults living in rural and urban communities. J Speech Lang Hear Res 2018; 61 (08) 2138-2145
• 5 Hay-McCutcheon MJ, Threadgill M, Yang X, Phillips F. Access to hearing health care, geographical residency, and quality of life in adults with and without hearing loss. J Am Acad Audiol 2020; 31 (07) 485-495
• 6 Shukla A, Harper M, Pedersen E. et al. Hearing loss, loneliness, and social isolation: a systematic review. Otolaryngol Head Neck Surg 2020; 162 (05) 622-633
• 7 Huang AR, Jiang K, Lin FR, Deal JA, Reed NS. Hearing loss and dementia prevalence in older adults in the US. JAMA 2023; 329 (02) 171-173
• 8 Pronk M, Deeg DJ, Kramer SE. Hearing status in older persons: a significant determinant of depression and loneliness? Results from the longitudinal aging study Amsterdam. Am J Audiol 2013; 22 (02) 316-320
• 9 Lin FR, Yaffe K, Xia J. et al; Health ABC Study Group. Hearing loss and cognitive decline in older adults. JAMA Intern Med 2013; 173 (04) 293-299
• 10 Hay-McCutcheon MJ, Brothers EB, Allen RS. An assessment of hearing health care needs in rural west central and South Alabama. Am J Audiol 2023; 32 (03) 487-499
• 11 Bircher J, Kuruvilla S. Defining health by addressing individual, social, and environmental determinants: new opportunities for health care and public health. J Public Health Policy 2014; 35 (03) 363-386
• 12 FDA. Medical Devices; Ear, Nose, and Throat Devices; Establishing Over-the-Counter Hearing Aids. Accessed March 3, 2025 at: https://www.federalregister.gov/documents/2022/08/17/2022-17230/medical-devices-ear-nose-and-throat-devices-establishing-over-the-counter-hearing-aids . Published 2022
• 13 National Institute on Deafness and Other Communication Disorders. Over-the-Counter Hearing Aids. Accessed March 3, 2025 at: https://www.nidcd.nih.gov/health/over-counter-hearing-aids#:~:text=You%20might%20have%20mild%20to,to%20repeat%20what%20they%20said . Published 2024
• 14 Lin FR, Niparko JK, Ferrucci L. Hearing loss prevalence in the United States. Arch Intern Med 2011; 171 (20) 1851-1852
• 15 O'Connor M, Fuller H, Cortez F. Technology use among older adults in rural areas. In: Innov Aging. Vol 2. © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: [e-mail]; 2018:679
• 16 Kumar M, Hickey S, Shaw S. Manual dexterity and successful hearing aid use. J Laryngol Otol 2000; 114 (08) 593-597
• 17 Humes LE, Kinney DL, Main AK, Rogers SE. A follow-up clinical trial evaluating the consumer-decides service delivery model. Am J Audiol 2019; 28 (01) 69-84
• 18 Humes LE, Rogers SE, Quigley TM, Main AK, Kinney DL, Herring C. The effects of service-delivery model and purchase price on hearing-aid outcomes in older adults: a randomized double-blind placebo-controlled clinical trial. Am J Audiol 2017; 26 (01) 53-79
• 19 Convery E, Keidser G, Seeto M, McLelland M. Evaluation of the self-fitting process with a commercially available hearing aid. J Am Acad Audiol 2017; 28 (02) 109-118
• 20 Brothers EB, Hay-McCutcheon MJ, Hughes PJ, Friend ML. Audiology, medicine, and pharmacy interprofessional preliminary interviews and discussions: improving hearing health care in rural Alabama. Am J Audiol 2022; 31 (03) 656-668
• 21 Berenbrok LA, Ciemniecki L, Cremeans AA, Albright R, Mormer E. Pharmacist competencies for over-the-counter hearing aids: a Delphi study. J Am Pharm Assoc (2003) 2021; 61 (04) e255-e262
• 22 Berenbrok LA, DeRuiter M, Mormer E. OTC hearing aids: an opportunity for collaborative working relationships between pharmacists and audiologists. J Am Pharm Assoc (2003) 2022; 62 (06) 1765-1768
• 23 Berenbrok LA, Chieffo N, Leong A, Stuck E, DeRuiter M, Mormer E. Opportunities for interprofessional collaboration between pharmacists and hearing professionals in Pennsylvania: a descriptive geographic information system study. JAPhA Practice Innovations. 2024; 1 (03) 100012
• 24 Gadd S, Lopez CE, Nelson CA. et al. Identifying key roles of the pharmacy technician in primary care settings. Am J Health Syst Pharm 2022; 79 (06) 460-466
• 25 Hill H, Cardosi L, Henson L. et al. Evaluating advanced pharmacy technician roles in the provision of point-of-care testing. J Am Pharm Assoc (2003) 2020; 60 (04) e64-e69
• 26 Sparkmon W, Barnard M, Rosenthal M, Desselle S, Ballou JM, Holmes E. Pharmacy technician efficacies and workforce planning: a consensus building study on expanded pharmacy technician roles. Pharmacy (Basel) 2023; 11 (01) 28
• 27 Taylor B, Mehta B. The community pharmacy technician's role in the changing pharmacy practice space. Innov Pharm 2020;11(02):
• 28 Shearer MP, Geleta A, Adalja A, Gronvall GK. Serving the Greater Good: Public Health and Community Pharmacy Partnerships. Johns Hopkins Center for Health Security; 2017
• 29 Cossette B, Ricard G, Poirier R. et al. Pharmacist-led transitions of care between hospitals, primary care clinics, and community pharmacies. J Am Geriatr Soc 2022; 70 (03) 766-776
• 30 Schindel TJ, Yuksel N, Breault R, Daniels J, Varnhagen S, Hughes CA. Perceptions of pharmacists' roles in the era of expanding scopes of practice. Res Social Adm Pharm 2017; 13 (01) 148-161
• 31 Hay-McCutcheon MJ, Berenbrok LA, Mormer E, Hughes PJ. Increasing access to hearing healthcare: an assessment of pharmacy technician educational training for the provision of over-the-counter hearing aids in rural Alabama and Mississippi pharmacies. National Institute on Deafness and other Communication Disorders; 2024
• 32 Stewart DW, Brown SD, Clavier CW, Wyatt J. Active-learning processes used in US pharmacy education. Am J Pharm Educ 2011; 75 (04) 68
• 33 Gleason BL, Peeters MJ, Resman-Targoff BH. et al. An active-learning strategies primer for achieving ability-based educational outcomes. Am J Pharm Educ 2011; 75 (09) 186
• 34 Stanley ER, Hafford A, Naseman R, Li J, Worley M, Mehta BH. Assessment of pharmacy technician learning preferences and implications for training. Am J Health Syst Pharm 2021; 78 (Suppl. 01) S16-S25
• 35 UPMC Center for Continuing Education in the Health Sciences. 2021 CHAMP: Championing Hearing Using Accessible Medication Experts at the Community Pharmacy. Accessed March 3, 2025 at: https://cce.upmc.com/2021-champ-championing-hearing-using-accessible-medication-experts-community-pharmacy#group-tabs-node-course-default6 . Published 2024
• 36 Ventry IM, Weinstein BE. The hearing handicap inventory for the elderly: a new tool. Ear Hear 1982; 3 (03) 128-134
• 37 Cox RM, Alexander GC. The International Outcome Inventory for Hearing Aids (IOI-HA): psychometric properties of the English version. Int J Audiol 2002; 41 (01) 30-35
• 38 Cox RM, Alexander GC. The abbreviated profile of hearing aid benefit. Ear Hear 1995; 16 (02) 176-186