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Updated: Aug 8, 2025

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Comparing Hearing Aid Outcomes in Adults Using Over-the-Counter and Hearing Care Professional Service Delivery Models
De Wet Swanepoel1,2,3,4, Ilze Oosthuizen1,2, Marien Alet Graham5
1Department of Speech-Language Pathology and Audiology, University of Pretoria, South Africa.
Purpose:
More affordable hearing aids are now available due to over-the-counter (OTC) hearing aid regulations. Although laboratory studies have validated many OTC hearing technologies, there are limited real-world benefit studies. This study compared hearing aid outcomes reported by clients from OTC and conventional hearing care professional (HCP) service delivery models.
Method:
An ecological, cross-sectional survey design was employed. An online survey was sent to the Hearing Tracker user and OTC Lexie hearing aid user databases. Moreover, 656 hearing aid users completed the survey-406 through conventional HCP services (M age = 66.7 ± 13.0 years) and 250 through the OTC model (M age = 63.7 ± 12.2 years). Self-reported hearing aid benefit and satisfaction were measured with the International Outcome Inventory for Hearing Aids outcome tool.
Results:
No significant difference for overall hearing aid outcomes between HCP and OTC users was evident using regression analyses, controlling for age, gender, duration of hearing loss, duration before hearing aid purchase, self-reported hearing difficulty, and unilateral versus bilateral fitting. For the "daily use" domain, HCP clients reported significantly longer hours of daily use. For the "residual activity limitations" domain, OTC hearing aid users reported significantly less difficulty hearing in situations where they most wanted to hear better.
Conclusions:
OTC hearing aid outcomes could complement and provide similar satisfaction and benefit to HCP models for adults. Service delivery aspects such as self-fitting, acclimatization programs, remote support, behavioral incentivization, and payment options should be investigated for their potential role in OTC hearing aid outcomes.
Supplemental Material:
https://doi.org/10.23641/asha.22134788.
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