Hearing aid use among Veterans with hearing loss and Veterans with normal audiometric thresholds due to self-perceived listening difficulties

Abstract: PURPOSE: The purpose of this study was to compare hearing aid use in a group of veterans with hearing loss and a group of veterans without measured hearing loss who present with self-perceived listening difficulties (SPLD) and no measured hearing loss. This study seeks to clarify whether individuals with SPLD engage with hearing aids similarly to those with hearing loss. METHOD: This retrospective record review included veterans aged 18-51 years. Two groups were identified: veterans with symmetric, high-frequency sensorineural hearing loss, and veterans with SPLD. Participants were new hearing aid users fitted with open-fit behind-the-ear or receiver-in-canal devices using zinc air batteries (size 312 or 13). Data were extracted from the Veterans Affairs' Computerized Patient Record System, including pure-tone thresholds, age, comorbidities, follow-up visits, hearing aid data logging (hours/day), self-report questionnaires, and hearing aid accessories dispensed. Hearing aid battery and supply orders were obtained from the Remote Ordering Entry System and used as a proxy for device use. The study also investigated differences in hearing aid usage and return visits. RESULTS: Data from 81 veterans with SPLD and 186 veterans with hearing loss were analyzed. Significant group differences were found in age, comorbidities (posttraumatic stress disorder, mental health conditions, pain, sleep impairments, and traumatic brain injury), hearing aid usage, return visits, and supply orders. Those with SPLD used their hearing aids significantly less, had fewer return visits, and ordered batteries and supplies significantly less. CONCLUSIONS: This study highlights significant differences in hearing aid use, supply orders, and return visits between the groups. Individuals with SPLD fit with hearing aids demonstrate less engagement with the hearing aids and are less likely to return for follow-up care. These results highlight the need for more individualized care approaches for SPLD, as standard amplification alone may not adequately address their listening challenges. Clinically, audiologists should consider comprehensive assessment and counseling strategies that extend beyond traditional amplification, including alternative interventions such as remote microphone technology, auditory training, or multidisciplinary referrals.