Increasing Access to Hearing Healthcare: An Assessment of Pharmacy Technician Educational Training for the Provision of Over-the-Counter Hearing Aids in Rural Alabama and Mississippi Pharmacies

Hearing loss is a major public health
concern due to its negative association with emotional well-being, cognition,
and physical ailments, such as diabetes. Access to audiologists and
otolaryngologists in many regions across the US is poor or extremely limited.
Rural populations are older, less educated, and have lower household incomes
compared to populations in metropolitan areas. Also, with increasing age adults
experience greater rates of hearing loss. Fortunately, the 2022 FDA Final Rule
for Over-the-Counter Hearing Aids (OTC HAs) could revolutionize assess to
hearing aids and hearing healthcare by allowing adults with perceived mild-to-moderate
hearing loss to purchase these devices over the counter, without medical
clearance or care from an audiologist. Pharmacies located in rural areas now
have the option to provide OTC HAs, something previously not possible. Currently,
however, there are no established guidelines for effective provision of these
devices in pharmacies located in rural communities. Educating pharmacy
technicians to provide basic hearing healthcare related to OTC HAs use could
address a critical need and create a new care delivery model to ensure
sustainable, long-term access to hearing healthcare. The long-term
goal of this study is to create a sustainable interprofessional
collaborative between audiologists and pharmacists for the development of a
hearing healthcare model that improves access and affordability of care in
rural regions across the country. The specific aims are to 1) Determine
an effective approach for educating pharmacy technicians for the provision of
OTC HAs in rural community pharmacies, and 2) Identify satisfaction of care provided by
pharmacy technicians and initial performance with OTC HAs in adults with
hearing loss living in rural communities. A stepped wedged clinical trial
design will be used to study the effectiveness of a comprehensive educational
training program for pharmacy technicians. Technicians from rural Alabama and
Mississippi, placed within four different clusters, will participate in a
multimodal training program for the purpose of developing basic clinical skills
to assist adults with perceived mild-to-moderate hearing loss. Additionally, adults with hearing loss who receive
clinical services from trained pharmacy technicians will be asked to report on
the care they received and benefit from their OTC HAs. The central hypotheses are a)
that pharmacy technician training will result in greater understanding of
hearing healthcare concepts compared to no training, and b) the training will
lead to successful provision of basic hearing healthcare to adults with hearing
loss in rural communities. The
expected outcome of this project will be the establishment of a
multimodal education program, leveraging the increased access of OTC HAs, to
support those with hearing loss in rural pharmacies across the county. The
ability of pharmacy technicians to provide this support will dramatically
increase the availability of hearing services in rural communities, which will
positively impact the quality of life for those with hearing loss.