Patient-Centered Hearing Intervention Leads to Positive Outcomes: The Association of Hearing Technology With Daily Hearing Aid Usage and Listening Goals in the Aging and Cognitive Health Evaluation in Elders Study

Purpose: This study describes the patient-centered approach to hearing technology selection and fitting of the participants randomized to a best practice hearing intervention as part of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study ( ClinicalTrials.gov identifier NCT03243422). We evaluated associations between hearing technology with daily hours of hearing aid use and listening and communication goal achievement. Method: The ACHIEVE study ( n = 977) was a multicenter, randomized controlled trial designed to test the effect of a best practice hearing intervention versus health education control on cognitive decline over 3 years among older adults with untreated hearing loss. Participants were aged 70–84 years, had adult-onset mild-to-moderate hearing loss, had no previous hearing aid use, and were without substantial cognitive impairment at baseline. Participants randomized to the hearing intervention ( n = 490) received a patient-centered comprehensive hearing program including hearing aids with varying feature sets, characterized as standard , advanced , and premium technology levels, and offered at least one hearing-assistive technology (HAT). The Client-Oriented Scale of Improvement (COSI) was used to identify listening needs that guided intervention delivery and was used to assess attainment of hearing-related goals following ~10-week intervention period. Hearing aid datalogging was used to measure hours of daily wear. We estimated the association between hearing aid technology level, HATs, hours of wear, and COSI goal attainment using an ordered logistic model adjusting for auditory and sociodemographic characteristics. Proportionality odds assumption was checked for all models. Results: A total of 459 participants completed the hearing intervention and reported outcomes. Selection of hearing aid technology level and HATs was guided through evidence-based protocol-directed recommendations, with 88 (19%) participants receiving standard; 260 (57%) participants, advanced; and 111 (24%) participants, premium hearing aid technology. Mean daily hours of hearing aid use was high ( M = 9.3 hr across all participants) and did not differ between hearing technology (levels or HATs). Participant COSI goals, which included categories such as conversation in noise and in quiet or attending church and/or meetings, improved and were not dependent on technology used. Participants benefited from patient-centered hearing intervention, and there were no statistically significant associations among hearing aid technology level, HATs, hours of use, and change in COSI goals. Conclusions: The patient-centered selection of hearing technology used in the ACHIEVE study resulted in high levels of hearing aid and HAT usage, along with positive COSI listening goal attainment for the majority of participants. Carefully assessed and selected technology is needed to meet individual auditory rehabilitation needs. Supplemental Material: https://doi.org/10.23641/asha.32069253