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A “landmark” proposal released last week by the U.S. Food and Drug Administration will introduce a new category of over-the-counter (OTC) hearing aids — available for purchase without consulting an audiologist.
While selling hearing aids directly to consumers will increase accessibility and decrease prices, it also brings audiology into the purview of pharmacists.
Two Pitt professors, Luke Berenbrok, associate professor of pharmacy and therapeutics in the School of Pharmacy and Elaine Mormer, director of audiology clinical education in the School of Health and Rehabilitation Sciences, are helping current and future pharmacists meet the challenge.
Through their online course, CHAMP: Championing Hearing Using Accessible Medication Experts at the Community Pharmacy, student pharmacists and practicing pharmacists gain foundational knowledge and competencies that can be applied immediately in a community pharmacy setting. Enrollees learn how to recognize the signs and symptoms of hearing loss, how to evaluate a patient’s eligibility for OTC hearing devices and how to refer a patient to an audiologist if the patient’s needs exceed OTC self care.
“This is not about pharmacists and OTC hearing aids replacing traditional, professional fittings. It’s more about increasing the number of people accessing these types of devices,” Berenbrok said. “The people who need the support of an audiologist will still be able to meet with an audiologist — it is that awareness all around is increasing.”
CHAMP launched for Pitt student pharmacists in April 2020, and by the end of the 2021-2022 school year, 350 student pharmacists will earn the online badge. Marketing CHAMP to external enrolled professionals will launch in the coming months.
Increased availability, decreased cost
“It’s estimated that 28.8 million U.S. adults could benefit from using hearing aids. However, only 30% of adults aged 70 and older and only 16% of adults aged 20 to 69 with hearing loss have ever used amplification devices,” Mormer said.
Professionally dispensed hearing aids — that is, hearing aids obtained via audiologist — cost on average more than $5,000 per pair, while Mormer estimates that an OTC hearing aid may be less than $1,000. Rolled into the cost of a professionally dispensed hearing aid is the price of custom fit, which relies on the expertise of a hearing aid fitter or an audiologist, as well as several trips to the audiologist’s office and the cost of warranties.
While OTC hearing aids offer savings, the programming of the hearing aid is solely on the consumer and relies on a smartphone app. The CHAMP course prepares pharmacists to help patients navigate setup issues.
“Some of the devices will have an 800 number helpline associated with it, but if you have hearing loss, there may be limits to your ability to use the phone,” Mormer said.
Another barrier to professionally dispensed hearing aids is geographical location.
A September article published in The Conversation by Berenbrok and Mormer noted that “audiologists tend to be located in metropolitan areas with higher incomes, younger populations and greater insurance coverage, with a smaller proportion of people who need hearing aids most — namely, older adults. In contrast, 90% of Americans live within 5 miles of one of the more than 60,000 community pharmacies nationwide.”
Berenbrok said the availability of OTC hearing aids will also increase pharmacists’ awareness of the work of audiologists.
“There's this big population of people who have hearing loss, and pharmacists can help push those people to audiologists. Much of pharmacy is done over the telephone, and that's one way you can tell if someone has some type of hearing loss,” she said.
Foundations of collaboration
The groundwork for CHAMP was laid in 2017, when Berenbrok invited Mormer and her class to join his students at SilverScripts, a community health outreach program where Pitt student pharmacists complete medication reviews for older adults.
Berenbrok, the director of SilverScripts, recognized that older adults could also benefit from hearing screenings. The goal of the collaboration was interprofessional education: students could better understand the impact of hearing loss on elderly patients, and audiology students could learn how to talk to their patients about medication use.
When Mormer prepped Berenbrok’s students for hearing screenings, she mentioned the FDA Reauthorization Act had passed just a few months prior.
“I realized that we needed to start educating pharmacists about OTC hearing aids,” Berenbrok said. "But in reality, no one in the pharmacy world is talking about it.”
— Nichole Faina