Randomized Trial of Telehealth vs Conventional Hearing Care Delivery in the ACHIEVE Study

ACHIEVE 研究中远程医疗与传统听力保健服务的随机试验

• 批准号: 10626871
• 负责人: FRANK R LIN
• 金额: $ 61.39万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10626871
• 关键词: Adult; Age; Aging; Area; Audiology; COVID-19 pandemic; Caring; Chronic; Clinic; Clinical; Cognitive; Communication; Communities; Complement; Congresses; Control Locus; County; Dementia; Education; Elderly; Evaluation; Follow-Up Studies; Funding; Future; Goals; Health; Health Educators; Healthcare; Hearing; Hearing Aids; Hour; Impaired cognition; Individual; Intervention; Investments; Measures; Medicare; Mental Health; Modeling; Outcome; Outcome Measure; Participant; Patient-Focused Outcomes; Patients; Persons; Physical Function; Policies; Provider; Psychological reinforcement; Randomized; Reporting; Research Personnel; Resources; Risk Factors; Role; Sampling; Self Efficacy; Self Management; Service delivery model; Services; Site; Social Functioning; Specific qualifier value; Technology; Time; Transportation; Visit; Washington; arm; care delivery; care systems; clinical care; cognitive function; cohort; efficacy trial; follow-up; functional outcomes; group intervention; health care model; healthy aging; hearing impairment; hearing loss treatment; improved; mental function; modifiable risk; multi-site trial; patient oriented; post intervention; primary outcome; racial diversity; randomized trial; recruit; secondary outcome; stem; telehealth; uptake

PROJECT SUMMARY Hearing loss is a chronic condition prevalent in two-thirds of adults >70 years and may be a potentially modifiable risk factor for adverse health outcomes including dementia. However, uptake and sustained use of hearing aids in adults is low, with <20% of older adults with hearing loss reporting use, among whom up to 30- 40% may discontinue hearing aid use over time. These limitations may stem in part from the reliance of the current best-practice model of hearing healthcare (HHC) on clinic-based visits that requires multiple in-person sessions between an audiologist and a patient for all ongoing technical and self-management support services. Incorporation of asynchronous and synchronous telehealth into HHC to complement clinic-based visits would allow for routine troubleshooting of communication challenges, hearing aid technical issues, and reinforcement of self-management support strategies. Determining if a HHC model that incorporates audiological telehealth improves long-term hearing aid use and other patient-centered outcome measures has direct implications for both future clinical care standards and ongoing Medicare legislative bills pertaining to HHC coverage. Our interdisciplinary consortium of investigators has a singular opportunity to evaluate the potential benefits of a telehealth audiology model on long-term hearing aid use and other outcomes in a large cohort of racially- diverse, community-dwelling older adults who are existing hearing aid users. In the ongoing Aging & Cognitive Health Evaluation in Elders (ACHIEVE) randomized trial, we recruited 977 adults ages 70-84 with untreated mild-to-moderate hearing loss from January 2018 to October 2019 who were randomized 1:1 to a hearing intervention (i.e., conventional clinic-based delivery of hearing services and technologies) versus a successful aging education control intervention. Participants are now being followed for 3 years post-randomization at the four ACHIEVE field sites, and the goal of this NIA-funded multisite trial (R01AG055426) is to determine if hearing loss treatment versus an aging education control intervention reduces cognitive decline. From 2021- 2022, as participants in the hearing intervention group (n=490) complete their pre-specified three years of follow-up in the ACHIEVE trial, we propose to recruit these existing hearing aid users and randomize them to receive either continued conventional clinic-based delivery of hearing care services or a model that incorporates telehealth. At 1 year post-randomization, the primary outcome (hours of hearing aid use) will be contrasted between the two groups, and participants in the conventional HHC arm will then cross-over and also receive telehealth HHC. All participants will continue to be followed for 2 years post-randomization. Aim 1: To compare the effect of the telehealth versus conventional HHC delivery model on hours of hearing aid use (primary outcome) and other patient-centered hearing and communication outcomes at 1 year post- randomization. Aim 2: To compare the effect of the telehealth versus the conventional HHC delivery model on secondary outcomes of social, mental, physical, and cognitive functioning at 1 year post-randomization.

项目总结