Improving patient communication around hearing loss comorbidities

Hearing loss does not occur in a vacuum. If my 40 years in the hearing industry have taught me anything, it’s just how deeply hearing loss affects individuals every single day. If you don’t personally struggle with hearing loss, it’s difficult to fully understand the ripple effects it has on every other area of an individual’s well-being, including mental, physical and emotional health.                                                             

For doctors, it’s important to recognize these impacts when communicating with patients and other providers. Many times, hearing loss is caused by other diseases – like diabetes and cardiovascular disease – and sometimes, hearing loss can lead to other diseases such as Alzheimer’s disease, dementia and depression. It can also cause dizziness and disequilibrium, which leads to falls.

While I think most primary care providers are aware of these comorbidities, we’re finding that many physicians are not making these connections a priority in their practice. The U.S. Preventive Services Task Force reaffirmed this in a 2011 study, when 85% of patients said their practitioners never talked to them about hearing screening unless the patient mentioned a hearing problem.

With so many other issues to discuss, it’s understandable why it can be tough for physicians to find the time to connect these dots. But it’s time for providers to shift their perspective. Rather than viewing hearing loss as an isolated communication issue, it’s critical to recognize the psychological, physiological and cognitive impacts of hearing loss when diagnosing and treating patients.

Diagnosing Hearing Loss Comorbidities Can Reduce Utilization, Healthcare Costs

Not only does recognizing comorbidities help improve patient outcomes, it can also contribute to significant cost savings for the healthcare system. A 2018 Journal of the American Medical Association study found persons with untreated hearing loss also experienced more inpatient stays and were at greater risk for 30-day hospital readmission. Preventing these catastrophic healthcare events begins with more patient screening and communication around hearing loss comorbidities.

Providers seeking to improve their patient communication in this area can should be on the lookout for five diseases that have a proven link to hearing loss issues and consequently, increased healthcare costs:

·       Diabetes: High glucose levels can damage blood vessels and nerves in the inner ear, resulting in hearing loss. Annual estimated cost: $16,752 per person (American Diabetes Association)

·       Cardiovascular disease: One of the first signs of cardiovascular disease is blood vessel trauma to the inner ear, which damages nerves and causes hearing loss. Annual estimated cost: $18,953 per person (American Journal of Managed Care)

·       Alzheimer’s disease and dementia: The constant strain to hear people can tire the brain and its functions. Hearing loss can also cause people to withdraw socially and accelerate cognitive decline. Annual estimated cost: $10,495 per person (Alzheimer’s Association)

·       Depression: Hearing loss takes an emotional toll, and can lead to anxiety, stress and alienation – all factors in clinical depression. Annual estimated cost: unknown

·       Dizziness, falls and disequilibrium: According to a 2012 Johns Hopkins study, hearing loss is tied to a three-fold risk of falling. Among older adults, falls are the leading cause of injury deaths, unintentional injuries, and hospital admissions for trauma. Annual estimated cost: $92-$30,000 per person depending on age and severity of injuries (Centers for Disease Control & Prevention and National Institutes of Health)

Comorbidities Make Hearing Care A Critical Aspect of Preventative Medicine

These strong links between hearing loss and other chronic diseases make it clear: hearing care is a critical component of preventative medicine. Unfortunately, hearing care can be prohibitively expensive for some patients. According to The Hearing Review(2014), people wait an average of seven years to get the hearing help they need.

Thankfully, we’ve seen policymakers make some incredible strides to ensure hearing aid coverage is standard for all insurers. In the meantime, patients can consult their local licensed hearing care center to see what type of resources they offer for affordable or no-cost hearing aids and screenings.

Hearing loss has wide-ranging consequences, and I encourage physicians to make recognizing these potential comorbidities a priority during their time with patients. Ultimately, a better understanding of these issues and how they affect one another will lead to improved outcomes for our patients in the future. And in both the hearing and medical communities - that’s something we’re all striving toward.

Dr. Thomas Tedeschi, Au.D. is chief of audiology and regulatory affairs for Miracle-Ear. He has more than 40 years of experience in the hearing healthcare industry and has worked in hospital-based, private practice, teaching and industry-related positions. He holds a doctorate degree in Audiology from Central Michigan University.