AGING
July 25, 2017

Over-the-Counter Hearing Aids

Personal sound amplification devices are likely to become available the way reading glasses are.

When a person loses their hearing, it sets in motion immediate and long-term consequences to their health and well-being. People with hearing loss can become socially isolated because they are unable to easily participate in and follow meaningful conversations or interact comfortably with family, friends and colleagues. This can lead them to withdraw and become depressed.

There are other issues, too. If unable to hear vehicles approaching while in cross walks, or warning signals when driving or walking, those with hearing loss are also at risk for accidents. Sketchy hearing may mean they don't fully hear important information, and it can contribute to concerns about dementia and cognitive deficits.

Personal sound amplification products or PSAPs have been compared to the reading glasses you buy at the drugstore. They do not require a doctor's visit for prescription and are significantly less expensive than traditional hearing aids.

While some causes of hearing loss are preventable, many are not. But hearing loss can be addressed with technology, specifically hearing aids. Though more than 30 million Americans experience hearing loss, including half of those between ages 70 to 79, only around 14 percent use hearing aids. Money is the main reason — hearing aids can cost several thousands of dollars and are not covered by Medicare or many private insurance plans. A lack of access to the technology necessary to keep hearing aids working and the specialists who can provide the necessary consultation and treatment are two other concerns.

A bipartisan bill was introduced in Congress in 2017 to make over-the-counter (OTC) hearing aids available at a much more reasonable price. These over-the-counter devices are known as personal sound amplification products or PSAPs. They've been compared to the reading glasses you buy at the drugstore because they do not require a doctor's visit for prescription, are significantly less expensive than traditional hearing aids, but may not be suited for those with more advanced or complicated hearing problems.

Critics cite the lack of expert evaluation prior to prescription of the devices and the lack of standardization of the products themselves. They are concerned that users will not be getting adequate help in making decisions about their purchases. Critics also assert that the devices will not be as high quality or effective as they should be and will mask, rather than solve, hearing problems. Supporters claim they will address a huge unmet need.

Coming to a Drug Store Near You?

To try to settle this debate, a team of researchers from Johns Hopkins University compared the hearing of 42 adults with mild to moderate hearing loss and normal cognition when using standard hearing aids and nine popular, currently available PSAPs.

They found that these PSAPs are effective for those with hearing loss. Many of these over-the-counter hearing aids helped those with mild to moderate hearing loss just as well as currently available prescription hearing aids did, and at a significantly lower cost.

A standard hearing aid improved participants' understanding of speech by 76 percent to 88 percent. Three of the tested PSAPs offered improvements that were within five percentage points of standard hearing aids. One variety of PSAP showed little improvement and one actually made hearing worse.

Personal sound amplification products can be a valuable and accessible way to improve the hearing of millions of seniors. It is reasonable to expect that their performance will continue to improve as they become commercially viable and the technology behind them further develops.

As the authors recommend, “Results lend support to current national initiatives from the National Academies, White House, and bipartisan legislation requesting that the US Food and Drug Administration create a new regulatory classification for hearing devices meeting appropriate specifications to be available over the counter.”

The study is published in JAMA.

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