Challenges and opportunities in direct-to-consumer hearing healthcare service delivery: a scoping review

Despite the rising prevalence of hearing loss worldwide, underutilization of hearing aids persists. Direct-to-consumer (DTC) hearing services have emerged as a potential solution to address barriers in conventional audiology services. This scoping review investigates the challenges and opportunities associated with direct-to-consumer service delivery in audiology. This review followed the Arksey and O'Malley and PRISMA-ScR guidelines. A systematic search of four databases and gray literature identified 12,034 records. Studies published in English between January 2015 and October 2024 were included if they explored challenges or opportunities in DTC hearing care service delivery from the perspectives of users aged 18 years or older with hearing loss or healthcare providers. After the screening and full-text review, 24 studies were included. The identified barriers included lack of professional guidance, safety concerns, limited user awareness and trust issues. Opportunities included improved accessibility, cost-effectiveness, integration of DTC into audiological practice, interprofessional collaboration, patient education and research comparing DTC and traditional service models. While DTC models can enhance access to hearing healthcare, overcoming challenges such as user education, trust, and professional involvement is crucial. Task shifting to other healthcare providers has emerged as a crucial strategy for enhancing service efficiency. The findings emphasise the need for a collaborative, multi-disciplinary approach to optimize DTC service delivery and inform future policy and practice.