TY - JOUR
T1 - The HEAR-VA Pilot Study
T2 - Hearing Assistance Provided to Older Adults in the Emergency Department
AU - Chodosh, Joshua
AU - Goldfeld, Keith
AU - Weinstein, Barbara E.
AU - Radcliffe, Kate
AU - Burlingame, Madeleine
AU - Dickson, Victoria
AU - Grudzen, Corita
AU - Sherman, Scott
AU - Smilowitz, Jessica
AU - Blustein, Jan
N1 - Funding Information:
This study is supported by VA HSR&D Merit Award (IIR 17-068). The Ralph S. French Charitable Foundation Trust provided additional support for the personal amplifiers provided to Veterans. The authors declare that they have no competing interests. Joshua Chodosh, Jan Blustein, Barbara Weinstein, Scott Sherman, and Corita Grudzen conceived and designed the trial. Madeleine Burlingame and Kate Radcliffe conducted data collection. Keith Goldfeld and Jan Blustein analyzed and interpreted the data. Joshua Chodosh and Jan Blustein prepared the manuscript. All authors reviewed and edited the manuscript. Keith Goldfeld, Kate Radcliffe, and Jessica Smilowitz are responsible for the integrity of the data. Joshua Chodosh approved the final version of the manuscript. All authors have read and approved the final submitted manuscript.
Publisher Copyright:
© 2021 The American Geriatrics Society
PY - 2021/4
Y1 - 2021/4
N2 - BACKGROUND/OBJECTIVES: Poor communication is a barrier to care for people with hearing loss. We assessed the feasibility and potential benefit of providing a simple hearing assistance device during an emergency department (ED) visit, for people who reported difficulty hearing. DESIGN: Randomized controlled pilot study. SETTING: The ED of New York Harbor Manhattan Veterans Administration Medical Center. PARTICIPANTS: One hundred and thirty-three Veterans aged 60 and older, presenting to the ED, likely to be discharged to home, who either (1) said that they had difficulty hearing, or (2) scored 10 or greater (range 0–40) on the Hearing Handicap Inventory-Survey (HHI-S). INTERVENTION: Subjects were randomized (1:1), and intervention subjects received a personal amplifier (PA; Williams Sound Pocketalker 2.0) for use during their ED visit. MEASUREMENTS: Three survey instruments: (1) six-item Hearing and Understanding Questionnaire (HUQ); (2) three-item Care Transitions Measure; and (3) three-item Patient Understanding of Discharge Information. Post-ED visit phone calls to assess ED returns. RESULTS: Of the 133 subjects, 98.3% were male; mean age was 76.4 years (standard deviation (SD) = 9.2). Mean HHI-S score was 19.2 (SD = 8.3). Across all HUQ items, intervention subjects reported better in-ED experience than controls. Seventy-five percent of intervention subjects agreed or strongly agreed that ability to understand what was said was without effort versus 56% for controls. Seventy-five percent of intervention subjects versus 36% of controls said clinicians provided them with an explanation about presenting problems. Three percent of intervention subjects had an ED revisit within 3 days compared with 9.0% controls. CONCLUSION: Veterans with hearing difficulties reported improved in-ED experiences with use of PAs, and were less likely to return to the ED within 3 days. PAs may be an important adjunct to older patient ED care but require validation in a larger more definitive randomized controlled trial.
AB - BACKGROUND/OBJECTIVES: Poor communication is a barrier to care for people with hearing loss. We assessed the feasibility and potential benefit of providing a simple hearing assistance device during an emergency department (ED) visit, for people who reported difficulty hearing. DESIGN: Randomized controlled pilot study. SETTING: The ED of New York Harbor Manhattan Veterans Administration Medical Center. PARTICIPANTS: One hundred and thirty-three Veterans aged 60 and older, presenting to the ED, likely to be discharged to home, who either (1) said that they had difficulty hearing, or (2) scored 10 or greater (range 0–40) on the Hearing Handicap Inventory-Survey (HHI-S). INTERVENTION: Subjects were randomized (1:1), and intervention subjects received a personal amplifier (PA; Williams Sound Pocketalker 2.0) for use during their ED visit. MEASUREMENTS: Three survey instruments: (1) six-item Hearing and Understanding Questionnaire (HUQ); (2) three-item Care Transitions Measure; and (3) three-item Patient Understanding of Discharge Information. Post-ED visit phone calls to assess ED returns. RESULTS: Of the 133 subjects, 98.3% were male; mean age was 76.4 years (standard deviation (SD) = 9.2). Mean HHI-S score was 19.2 (SD = 8.3). Across all HUQ items, intervention subjects reported better in-ED experience than controls. Seventy-five percent of intervention subjects agreed or strongly agreed that ability to understand what was said was without effort versus 56% for controls. Seventy-five percent of intervention subjects versus 36% of controls said clinicians provided them with an explanation about presenting problems. Three percent of intervention subjects had an ED revisit within 3 days compared with 9.0% controls. CONCLUSION: Veterans with hearing difficulties reported improved in-ED experiences with use of PAs, and were less likely to return to the ED within 3 days. PAs may be an important adjunct to older patient ED care but require validation in a larger more definitive randomized controlled trial.
KW - Veterans
KW - communication
KW - emergency departments
KW - hearing loss
UR - http://www.scopus.com/inward/record.url?scp=85100868087&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100868087&partnerID=8YFLogxK
U2 - 10.1111/jgs.17037
DO - 10.1111/jgs.17037
M3 - Article
AN - SCOPUS:85100868087
VL - 69
SP - 1071
EP - 1078
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
SN - 0002-8614
IS - 4
ER -