Purpose: More affordable hearing aids are in view with the pending over-the-counter (OTC) hearing aid regulations. While laboratory studies have validated many OTC hearing technologies, there are limited real-world benefit studies. This study compared hearing aid outcomes reported by clients from an emerging OTC  and conventional hearing care professional (HCP) service-delivery models.

Method: Prospective cross-sectional survey design was employed. An online survey was sent to the Hearing Tracker user and the OTC Lexie hearing aid user databases. 656 hearing aid users completed the survey; 406 through conventional HCP services (mean age 66.7 ± 13.0 years) and 250 through the OTC model (mean age 63.7 ± 12.2 years). Self-reported hearing aid benefit and satisfaction was measured with the International Outcome Inventory for Hearing Aids outcome tool.

Results: No significant difference for overall hearing aid outcomes between HCP and OTC users were evident using regression analyses controlling for age, gender, duration of hearing loss, duration before hearing aid purchase, self-reported hearing difficulty, and unilateral versus bilateral fitting. For Daily use, HCP clients reported significantly longer hours of daily use. For residual activity limitation, OTC hearing aid users reported significantly less difficulty hearing in situations where they most wanted to hear better.

Conclusions: OTC hearing aid outcomes could complement and provide similar satisfaction and benefit to HCP models for older adults. Service delivery aspects such as self-fitting, acclimatization programs, remote support, behavioral incentivization and payment options should be investigated for their potential role in OTC hearing aid outcomes.