Discrepancies between insertion and target gain are associated with hearing aid abandonment in Chilean older adults

Despite the known benefits of hearing aids in age-related hearing loss (ARHL), abandonment rates remain notably high in certain South American countries. Understanding factors that contribute to abandonment is critical, given the resources allocated and the adverse outcomes of leaving ARHL untreated. This study aimed to examine the association of discrepancies between insertion and target gain with the risk of hearing aid abandonment We conducted a retrospective cohort study of 455 individuals receiving publicly funded hearing aids in two Chilean regions. Discrepancies between insertion and target gain were determined using a hearing aid analyzer, and abandonment was identified by self-report. Poisson regression models evaluated the association between insertion gain and abandonment, controlling for potential confounders. Overall, 18% of participants discontinued hearing aid use. Among those who abandoned, the discrepancy between insertion and target gain at 65 dB was 7.8 dB, whereas in those who continued, it was 5.8 dB. After incorporating other predictors, each 1 dB increase in discrepancy was associated with a 10% elevated risk of abandonment (RR = 1.10; 95% CI: 1.06-1.15). Attending up to four follow-up appointments may further improve alignment with target gain. These findings underscore that precise insertion gain relative to the target can reduce abandonment. Ensuring alignment through comprehensive fitting and regular follow-up could significantly enhance adherence. Public policies supporting monitoring and frequent reassessment may optimize hearing aid adherence and resource utilization, thereby partially mitigating the long-term impact of untreated hearing loss.