LM408 - Best Practices Hearing Intervention: The ACHIEVE Way

Abstract:
In the dynamic world of healthcare, the need for structured intervention protocols has never been more apparent. The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) multi-site clinical trial stands as a testament to this imperative. Specifically, the development and implementation of an evidence-based hearing intervention within ACHIEVE underscores the significance of tailored treatments in clinical practice.
This session will provide a detailed overview of best-practice audiological intervention as modeled in the ACHIEVE study and give participants a toolkit that can readily be implemented in a clinical setting.

Summary:
Much attention has been paid to the development of evidence-based practice (EBP) for the management of hearing loss in adults (BSA, 2016; Valente et al., 2006). While such guidelines are useful, they do not provide the kind of structured intervention protocol that is needed in a large-scale multisite randomized controlled trial. Thus, an evidence-based hearing intervention (Sanchez et al., 2020) for use in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) multi-site clinical trial was developed. ACHIEVE was designed to investigate whether hearing loss intervention vs. a health education control reduces the risk of cognitive decline and dementia in older adults.

For older adults with untreated hearing loss, implementation of a comprehensive hearing intervention can serve as a potential mediator to reduce risks associated with comorbid conditions including depression and cognitive decline. Recognizing this, the ACHIEVE hearing intervention spanned four sessions, conducted over 8-10 weeks, and offered a multifaceted approach: Individualized Listening Goals: Acknowledging that every patient's journey is unique, the intervention starts by setting personalized listening objectives. Hearing Aid Technology: Participants benefited from a wide range of hearing aid technology options, spanning from standard to premium, ensuring that auditory needs are met. Technological Intervention: Hearing assistive devices further enhanced the intervention by addressing specific hearing challenges, such as hearing in noise or at a distance. Educational: A holistic approach to care set expectations and increased participants’ self-management during difficult communication situations.

Central to the success of the ACHIEVE hearing intervention was the meticulous selection of fitting decisions. Audiologists considered factors such as receiver strengths and dome sizes to optimize audibility, sound quality, and feedback prevention while ensuring the utmost comfort for the patients. Selections were verified to be appropriate using best-practice real ear measures to ensure that every device was fit to prescriptive target.

The ACHIEVE trial recognized the value of individualization. Baseline information on participant demographics, audiometric profiles, and listening goals provided a foundation for tailor-made care. An additional key to the success of this intervention was comprehensive aural rehabilitation. Counseling on communication tactics and skills was provided through multiple instructional modes including discussions, handouts, and videos. Outcome measurements of goal achievement, perceived hearing aid benefit, and daily hearing aid use were utilized to inform topics in future appointments. These tools and strategies will be shared during the Learning Module.

In a world where healthcare is increasingly personalized, this course will help translate the clinical implications of the ACHIEVE hearing intervention to real-world application. Participants will leave with evidence-based interventions and a toolkit for in-clinic success.