With record numbers of people being diagnosed with hearing loss, pharmacists are in an ideal position to advise patients about aural health

In November 2015, Action on Hearing Loss reported that hearing loss is a major public health issue in the UK, now affecting more than 11 million people. And it’s estimated that by 2035 it will affect more than 15.6 million people in the UK – a fifth of the population. According to the charity’s Hearing Matters report, urgent action is needed to improve the diagnosis of hearing loss, and to encourage more people to wear hearing aids if they require them.

In the Annual Health Survey for England 2014 report, which was published in December 2015, 18 per cent of adults reported hearing difficulties. Yet only 5 per cent of those surveyed said they used a hearing aid. More than two in five adults reporting great hearing difficulties had never used a hearing aid at all, while around one in 10 of this group had used them in the past but was not currently using them.

Hearing aids are most effective when they are fitted early on, but evidence shows that there is an average of a 10-year delay in people seeking help. And when people eventually do seek help, GPs fail to refer 45 per cent of those reporting hearing loss to NHS hearing services. With proposed cuts to NHS hearing loss services in some parts of the country, there are fears that the issue could escalate.

So could community pharmacies help to address the poor diagnosis rate? According to Sultan “Sid” Dajani, independent community pharmacist and member of the RPS English Pharmacy Board, there are huge opportunities for pharmacies in aural health.

“Many of the multiples are moving into audiology, and independent pharmacies could soon follow,” he says. “Pharmacies already stock disability aids, which can help to identify suitable patients, and pharmacists could use their consultation room for an audiologist on one or two days each week. Hearing checks in the pharmacy can provide additional revenue, as well as a useful service for customers.”

Improving access

According to the 2013 Access All Areas report by Action on Hearing Loss, it’s becoming increasingly common for health advice to be delivered outside a GP setting, including through pharmacies. Private consultation rooms in the pharmacy are important for patient confidentiality, but can also aid communication by reducing background noise. The report concluded that pharmacists should ensure that private rooms are available for patient consultations, extend the use of technology that can help improve the patient experience for people with hearing loss, such as induction loop or infrared systems, and provide deaf awareness training for all staff who come into contact with patients.

Louise Hart, senior audiologist at Action on Hearing Loss, says people often visit a pharmacy more regularly than their GP and this is why pharmacists have an important role to play. “Local pharmacists often know the characteristics of their local population and their customers/clients well,” she says.

“They are seen as very trustworthy and their advice is valued. So they may be able to encourage people to get their hearing checked or even volunteer to have a local audiologist do a screening event. Information stands with pamphlets on hearing loss and ear issues would be helpful too, and in some more remote areas, the pharmacy could become a place where people can collect their hearing aid batteries from their local health service. Pharmacists can get more involved by understanding who the local providers of hearing services are and having good links with them, so that if a person’s hearing changes or they are having issues, they can be encouraged to return to, or see, an audiologist.”

One in 10 adults across the UK suffers from tinnitus, which can affect people of all ages and may develop after exposure to loud noise. According to Ms Hart, people with tinnitus symptoms may be more comfortable asking a pharmacist for advice rather than a GP. “A pharmacist may be the first access point, so it’s important that they can put that person at ease, provide information and refer them onwards for support,” she says. “They may even be able to stock or suggest products such as a sound relaxer, which is also available through the Action on Hearing Loss website.

Pharmacy advice

Mr Dajani believes aural health involves three main issues from a pharmacy point of view. “It’s all about cleanliness, ear health and correct diagnosis,” he says. “When a customer asks for products for their ears, I always check what the underlying problem is and that they don’t have a sinus problem instead. Sinusitis is a common cause of ear pain, and I often end up selling decongestants rather than products for the ear itself.”

According to Care, whose Olive Oil Eardrops can be used to soften ear wax, one in 10 parents admits they have accidentally lodged a cotton bud in their child’s ear. Pushing too hard with the cotton bud can, in some cases, lead to superimpacted wax and even a perforated eardrum. “Ear wax is another issue that people often ask about and I always tell customers they shouldn’t stick anything in their ear,” says Mr Dajani. “I recommend they use olive oil for five to seven days, followed by ear syringing. I now perform this myself in the pharmacy, which saves customers visiting their GP surgery. But obviously if I feel there is an actual hearing issue, or a problem with the ears themselves, I would always refer someone to their GP for advice.”

Many people with hearing loss don’t realise they have a problem. They may just think their family members talk quietly or television programmes are not as clear as they used to be. Although hearing loss can be associated with getting older, it can also be triggered by noise damage, general health (for example, even wellmanaged diabetes) and family history.

Mr Dajani says that pharmacists are ideally placed to advise customers about appropriate ear protection. “I stock professional noiseprotection ear muffs, particularly for workmen,” he says. “Tinnitus is a growing issue, yet it can often be prevented easily with the right products.”

Pharmacists could use their consultation room for an audiologist on one or two days each week. Hearing checks in the pharmacy can provide additional revenue, as well as a useful service for customers

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