Tinnitus & Hyperacusis Therapy Masterclass

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Specialist course for management of tinnitus and hyperacusis in children and adults


Non-regular use of hearing aids

A meta-analysis showed that hearing aids (HAs) had a medium-to-large effect on health-related quality of life (Chisolm et al. 2007). Despite this, a recent study in National Health Service (NHS) in the United Kingdom showed that 29% of people (293/1021) do not use their NHS HAs regularly (i.e., use less than 4 hours per day) (Aazh et al. 2015). The non-regular use was 39.5% for new patients (Aazh et al. 2015). Previous studies in NHS also reported 43% to 45% for non-regular use (Stephens 2002; Davis et al. 2007).

In NHS, the choice of HAs is limited. In other countries, patients may have the choice of several HA makes. Despite this, non-regular use in NHS is comparable to that found in other countries: 27% and 58% in two Australian studies (Hickson et al. 2010; Stark & Hickson 2004), 42% in Finland (Vuorialho et al. 2006), 13% to 31% in four studies conducted in the USA (Kochkin 2010; Takahashi et al. 2007; Williams et al. 2009), and 25% in Switzerland (Bertoli et al. 2009). For further detail see Aazh et al (2015).  

The exact reasons for non-regular use of hearing aids is not fully understood (Aazh 2016). However, it seems that the discrepancy between patients’ expectations (e.g., full restoration of hearing, a “cure”) and what a hearing aid can offer may contribute to the ambivalence experienced by some (Boothroyd 2007). A phenomenological study suggested that some patients do not regard HAs as acceptable solution but agree to get them mainly to please their partner or family members (Claesen & Pryce 2012). Two systematic reviews concluded that stigma of deafness and self-reported hearing difficulties are the main barriers to HA use (Knudsen et al. 2010; Jenstad & Moon 2011). 


The protocol and clinical manual of Motivational Interviewing (MI) for hearing aid use taught in this masterclass synthesises the knowledge gained through decades of research in the field of rehabilitative audiology and amplification with relevant concepts of modern psychology and behaviour change. This protocol, which developed by Dr. Hashir Aazh and his team over the years, describes an evidence-based method which is feasible to be delivered in day-to-day outpatient audiology clinics and fine tuned base on in-depth evaluation and qualitative assessment of patients’ feedback and the outcome of clinical research.          




Aazh, H. (2016). Patients' experience of motivational interviewing for hearing aid use: A qualitative study embedded within a pilot randomised controlled trial. J Phonet and Audiol, 2, 1-13.

Aazh, H., Prasher, D., Nanchahal, K., et al. (2015). Hearing-aid use and its determinants in the UK National Health Service: A cross-sectional study at the Royal Surrey County Hospital. Int J Audiol, 54, 152-161.

Bertoli, S., Staehelin, K., Zemp, E., et al. (2009). Survey on hearing aid use and satisfaction in Switzerland and their determinants. Int J Audiol, 48, 183-95.

Boothroyd, A. (2007). Adult aural rehabilitation: what is it and does it work? Trends Amplif, 11, 63-71.

Chisolm, T. H., Johnson, C. E., Danhauer, J. L., et al. (2007). A systematic review of health-related quality of life and hearing aids: final report of the American Academy of Audiology Task Force On the Health-Related Quality of Life Benefits of Amplification in Adults. J Am Acad Audiol, 18, 151-83.

Claesen, E., & Pryce, H. (2012). An exploration of the perspectives of help-seekers prescribed hearing aids. Prim Health Care Res Dev, 13, 279-84.

Davis, A., Smith, P., Ferguson, M., et al. (2007). Acceptability, benefit and costs of early screening for hearing disability: a study of potential screening tests and models. Health Technol Assess, 11, 1-294.

Hickson, L., Clutterbuck, S., & Khan, A. (2010). Factors associated with hearing aid fitting outcomes on the IOI-HA. Int J Audiol, 49, 586-95.

Jenstad, L., & Moon, J. (2011). Systematic review of barriers and facilitators to hearing aid uptake in older adults. Audiology Research, 1, e25.

Knudsen, L. V., Oberg, M., Nielsen, C., et al. (2010). Factors influencing help seeking, hearing aid uptake, hearing aid use and satisfaction with hearing aids: a review of the literature. Trends Amplif, 14, 127-54.

Kochkin, S. (2010). MarkeTrak VIII: Consumer satisfaction with hearing aids is slowly increasing. The Hearing Journal, 63, 19-20.

Stark, P., & Hickson, L. (2004). Outcomes of hearing aid fitting for older people with hearing impairment and their significant others. Int J Audiol, 43, 390-8.

Stephens, D. (2002). The International Outcome Inventory for Hearing Aids (IOI-HA) and its relationship to the Client-oriented Scale of Improvement (COSI). Int J Audiol, 41, 42-7.

Takahashi, G., Martinez, C. D., Beamer, S., et al. (2007). Subjective measures of hearing aid benefit and satisfaction in the NIDCD/VA follow-up study. J Am Acad Audiol, 18, 323-49.

Vuorialho, A., Karinen, P., & Sorri, M. (2006). Effect of hearing aids on hearing disability and quality of life in the elderly. Int J Audiol, 45, 400-5.

Williams, V. A., Johnson, C. E., & Danhauer, J. L. (2009). Hearing aid outcomes: effects of gender and experience on patients' use and satisfaction. J Am Acad Audiol, 20, 422-32; quiz 459-60.