Knoetze, M., Manchaiah, V., & Swanepoel, D.W.
Journal of the American Academy of Audiology, In Press.
Publication year: 2024

Purpose: Over-the-counter (OTC) hearing aids can potentially improve access to hearing healthcare and enable individuals with mild-to-moderate hearing loss to self-manage their condition. This study compares usability and performance across a range of self-fitting over-the-counter (OTC-SF) hearing aids.

Research Design: A cross-sectional study evaluated six OTC-SF hearing aids.

Study Sample: 43 adults with self-perceived mild-to-moderate hearing difficulties participated.

Data Collection and Analysis: Participants were randomly assigned to self-fit two of six OTC-SF hearing aids using manufacturer-provided instructions and smartphone applications. These included the HP Hearing PRO, Jabra Enhance Plus, Lexie B2 Powered by Bose, Lexie Lumen, Soundwave Sontro, and Sony CRE-C10. Usability was assessed based on fitting time, Hearing Aid Skills and Knowledge (HASK), self-reported ease of the self-fitting process, and the Post-Study System Usability Questionnaire (PSSUQ). Performance was evaluated with the Judgement of Sound Quality (JSQ) test and speech-in-noise benefit using the Digits-In-Noise (DIN) and QuickSIN tests.

Results: Fitting time ranged between 14.4 and 27.1 minutes, with Lexie Lumen requiring the longest (27.1; SD 5.9) and HP Hearing PRO the shortest (14.4; SD 1.9). HASK scores varied, with Soundwave Sontro scoring highest (8.9/10) and HP Hearing PRO lowest (6.8/10). Self-reported ease of self-fitting and PSSUQ scores did not differ significantly between the OTC-SF hearing aids. Overall sound quality and clarity ratings significantly differed, with Lexie B2 receiving the highest ratings (8.1/10 and 7.5/10) and HP Hearing PRO the lowest (6.3/10 and 5.1/10). Speech-in-noise benefit did not differ significantly between devices. Thematic analysis identified seven themes regarding the participant’s self-fitting experience and six themes related to the researcher’s field notes. Participants generally found OTC-SF hearing aids user-friendly, although issues with Bluetooth connectivity, handling and insertion, and sound quality were noted as common challenges by the researcher.

Conclusions: Usability and performance of OTC-SF hearing aids were similar across devices in terms of post-usability and speech-in-noise benefit. However, devices showed variations in fitting time, HASK, and sound quality, including overall impression and clarity. These findings can support consumers and healthcare professionals in decision-making and recommendations. Further research is needed on long-term usability and selection processes for OTC-SF hearing aids.