Doctors believe that communication with their patients is important, but most studies of physician/elderly patient communication do not mention that hearing loss may affect this interaction. The findings come from a review led by two NYU professors published in the Journal of the American Geriatrics Society.
Many researchers have explored communication between doctors and their patients, but how many of them have considered the importance of hearing loss? To investigate this question, a team led by Dr. Joshua Chodosh of New York University School of Medicine and Dr. Jan Blustein, the NYU's Robert F. Wagner School of Public Service and the School of Medicine, reviewed the published medical literature on doctor-patient communication, selecting research studies that involved patients aged 60 years and older.
Of the 67 papers included in their study, only 16 (23.9%) included any mention of hearing loss. In some cases (4 out of the 67), people with hearing loss were excluded from the study. Three of the studies reported on an association between hearing loss and quality of care. In only one study did the researchers offer patients some kind of hearing assistance to see whether it would improve communication. (It found that offering hearing assistance improved patients' understanding.)
"Hearing loss has long been neglected in the medical community," said Chodosh. "As a geriatrician, I see many patients who struggle to hear what I'm saying to them. That makes me less certain that they are getting what they need."
The findings suggest that research on physician-elderly patient communication has largely overlooked a highly prevalent, important, and remediable influence on the quality of communication.
"Patients are often older people, for whom hearing loss is a daily issue. It's also an issue that's ripe for research: how can we attend to and improve hearing and understanding so that patients get the best quality care possible?" said Blustein.
In an accompanying editorial, Frank Lin, MD, PhD of the Johns Hopkins School of Medicine and Heather Whitson, MD, MHS of the Duke University School of Medicine noted that the review offers a major opportunity for practice improvement. "Common sense, low (or no) cost strategies can be employed to mitigate the negative impact of both hearing and vision loss in patient communication," they wrote. "And some accommodations (e.g., minimizing ambient noise, speaking face to face, creating patient education materials with large-print font) are so simple and potentially beneficial that they could be implemented universally."
Journal of the American Geriatrics Society