Hearing problems in adults; mapping the patient pathway and burden recorded within the NHS.

Date of Approval
Application Number
16_185
Lay Summary

Hearing is key to our ability to communicate and is a key component for health and wellbeing. Hearing loss affects people socially, emotionally and physically and has been linked to dementia, a condition in which progressive mental decline and memory loss become severe enough to interfere with daily life. It is estimated that over 10 million UK people suffer from hearing loss costing the economy £30 billion a year. With our population ageing this impact is set to increase. UK figures on healthcare utilisation for hearing loss, based on routine NHS data, are missing.

We will utilise GP and hospital data to study the adult patient pathway from initial complaint of hearing loss to the provision of hearing aids: exploring how often hearing tests are performed, hearing loss diagnoses made, and hearing aids provision are recorded in medical records. We will use this information to better understand how hearing loss impacts on healthcare utilisation and patients’ health.

This research will raise awareness of the impact of hearing loss on people and the NHS. This research is vital for future research looking into preventing and treating hearing loss and to design services that enhance healthy ageing.

Technical Summary

The objectives are to:

1. a) estimate the proportion of adults that have age-related hearing loss recorded in their medical records and compare this with existing prevalence estimates.
b) map clinical healthcare pathways for patients with hearing loss recorded within the NHS while exploring data completeness of data recording across all data sources used.
2. a) compare characteristics (e.g. age, sex, social deprivation, dementia diagnosis),
b) estimate prognosis (e.g. health care utilisation, all-cause antibiotic prescription [as proxy for health], comorbidities, mortality) of patients with and without age-related hearing loss and
3. compare the prognosis of patients who receive audiological care (including hearing aid hearing aid(s)) earlier compared to those who receive care later or not at all.

Objective 1 will inform later analysis decisions. The analysis in 1a-b) is purely descriptive. We will use logistic regression to compare baseline characteristics of people with age-related hearing loss to those without (Objective 2a) and compare baseline characteristics of people who receive audiological care (including hearing aid(s) fitting) earlier or later/not at all (Objective 3a). Multivariable Poisson and cox proportional hazards models as well as matching (e.g. frequency/propensity score matching) will be used to compare prognoses in objective 2b and 3b.

Health Outcomes to be Measured

Age-related hearing loss Dementia and death

Collaborators

Nishchay Mehta - Chief Investigator - University College London ( UCL )
Nishchay Mehta - Chief Investigator - University College London ( UCL )
Nishchay Mehta - Corresponding Applicant - University College London ( UCL )
Nishchay Mehta - Corresponding Applicant - University College London ( UCL )
Andrew Hayward - Collaborator - University College London ( UCL )
Anne Schilder - Collaborator - University College London ( UCL )
Greta Rait - Collaborator - University College London ( UCL )
Hannah Evans - Collaborator - University College London ( UCL )
Rolf H.H. Groenwold - Collaborator - University Medical Centre Utrecht
Spiros Denaxas - Collaborator - University College London ( UCL )

Linkages

HES Admitted Patient Care;HES Outpatient;ONS Death Registration Data;Patient Level Index of Multiple Deprivation;Practice Level Index of Multiple Deprivation