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Neuro-rehabilitation Approach for Sudden Sensorineural Hearing Loss
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Association Between Polypharmacy and Self-Reported Hearing Disability: An Observational Study Using ATC

Francesco Martines1, Pietro Salvago1, Gianluca Lavanco2

  • 1Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Section of Audiology, University of Palermo, Via del Vespro, 129-90127 Palermo, Italy.

Audiology Research
|October 28, 2025
PubMed
Summary

Taking multiple medications increases the risk of hearing loss, with certain drug classes posing a higher risk. Antidiabetic drugs may offer a protective effect against hearing impairment.

Keywords:
ATC classificationdrugs-related side effectshearing losspolypharmacy

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Area of Science:

  • Audiology
  • Pharmacology
  • Public Health

Background:

  • Hearing loss is a significant global health issue, particularly in adulthood.
  • It can be exacerbated by underlying pathologies and polypharmacy (concurrent use of multiple drugs).

Purpose of the Study:

  • To investigate the association between drug use and self-reported hearing loss in a diverse patient cohort.
  • To explore the relationship between polypharmacy, specific drug classes, and hearing impairment.

Main Methods:

  • An observational study involving 1651 patients (aged 18-99) with detailed pathological and pharmacological profiles.
  • Self-reported hearing loss was assessed using the HHIE-S-It questionnaire.
  • Drug categorization utilized the Anatomical Therapeutic Classification (ATC) system.

Main Results:

  • Patients on mono- or polytherapy exhibited greater hearing deficits compared to non-drug users.
  • A dose-response relationship was observed: increased drug count correlated with higher risk of moderate to severe hearing impairment.
  • Cardiovascular and acid-related disorder drugs were linked to increased hearing impairment risk; antidiabetic agents showed a protective effect.

Conclusions:

  • Both the quantity and specific types of medications influence perceived hearing impairment.
  • Audiological evaluation should be integrated into polypharmacy management.
  • Findings support the development of safer, personalized therapeutic strategies.