Kruger, M., Pandey, P., Manchaiah, V., & Swanepoel, D.W.
Trends on Hearing, In Press.
Publication year: 2026

Digital interventions are increasingly used to support hearing aid users; however, evidence for first-time hearing aid users remains unclear. This systematic review and meta-analysis evaluated the efficacy and effectiveness of digital interventions to improve outcomes for first-time hearing aid users. The protocol was pre-registered (PROSPERO; CRD420251125785) and conducted in accordance with PRISMA 2020. PubMed, Scopus, and Web of Science were searched (January 2026). Eligible studies included randomized controlled trials, controlled clinical trials, and quasi-experimental studies evaluating internet-, app-, or web-based interventions. Outcomes were grouped into six domains: hearing aid use, benefit and satisfaction, hearing and communication, knowledge, skills and self-management,  speech-in-noise performance, and psychosocial and emotional adjustment. Risk of bias was assessed using RoB 2 and ROBINS-I, and certainty of evidence using GRADE. Random-effects meta-analyses were conducted where ≥3 randomized trials reported comparable outcomes. Eleven publications (nine trials) were included. Most interventions focused on education, self-management, and counseling, with few targeting perceptual training. The most consistent improvements were observed in knowledge, skills and self-management (moderate-certainty). Evidence for hearing aid use, benefit and satisfaction, hearing and communication, and psychosocial and emotional adjustment was limited and inconsistent (low-certainty), while speech-in-noise evidence was of very low certainty. Meta-analyses of hearing aid use and IOI-HA outcomes showed no significant pooled effects. Digital interventions show the most consistent evidence for improving knowledge, skills, and self-management. Evidence for other outcomes remains limited and inconsistent. Clinicians may consider digital educational programs complementing standard care. Future research should prioritize larger, pre-registered trials with broader interventions and standardized outcomes.