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Hearing issues – who’s listening?

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Hearing issues – who’s listening?

The ear care category could be extended in the pharmacy to help people recognise hearing problems

Ear problems are a common reason for a pharmacy visit, and ear wax and mild otitis externa are the two ear conditions that can be treated from the pharmacy. However, hearing problems still present something of a dilemma for most healthcare providers.

Whether it’s common problems like tinnitus, loss of hearing or access to hearing services, there’s certainly demand for more support for hearing problems nationwide.

Action on Hearing Loss (formerly RNID) and the Biotechnology and Biological Sciences Research Council (BBSRC) have recently announced that they are investing £4 million into hearing research, supporting 13 new projects in total with research into treatments for tinnitus, identifying genetic causes of hearing loss and developing more accurate hearing tests.

Dr Sohaila Rastan, executive director of biomedical research at charity Action on Hearing Loss, says: ‘Despite the scale of the issue and the severe impact it can have on people’s quality of life, research into effective treatments receives scant funding compared to other health conditions, which is why we are delighted to have been able to work with the BBSRC to strengthen this important area of research.’

The problems associated with hearing loss can have a significant impact. ‘Hearing loss, if undiagnosed or mismanaged, can increase vulnerability to social isolation, depression and
reduce employment opportunities.

Investment in research to prevent hearing loss and restore hearing has the potential to not only improve the quality of life for millions of people across the UK, but save the economy millions of pounds.’

Hearing the issues

People who work with deaf and hearing-impaired clients understand that hearing loss can impact on quality of life, although in some cases the emphasis on ‘fixing’ deafness can cause more problems that adapting to accommodate hearing loss.

A British Sign Language interpreter who frequently accompanies clients to medical appointments told us about her frustration at the way deaf people are sometimes catered for by the medical profession. This is food for thought for pharmacies, hospitals and GP practices.

‘The biggest issue facing deaf people is communication,’ she says. ‘That may sound
obvious, but I know my clients can become very frustrated when faced with receptionists and
nurses, even at ear, nose and throat departments, who have no basic deaf awareness or sign
language skills. It’s silly things like shouting out a deaf person’s name when it’s time for their
appointment, not looking up at the client when they attend an appointment, or mumbling, so that it’s hard for the deaf person to understand.’

This interpreter believes that it’s vital that deaf people are supported in the community – more awareness of the services available would help and could even save lives.

  • One in six of the UK population has some form of hearing loss.
    ô€€€
  • More than 800,000 people in the UK are severely or profoundly deaf.
    ô€€€
  • More than 70 per cent of over- 70-year-olds and 40 per cent of over-50-year-olds have some form of hearing loss.
    ô€€€
  • About two million people in the UK have hearing aids, but only 1.4 million use them regularly.
    ô€€€
  • At least four million people who don't have hearing aids would benefit from using them.
    ô€€€
  • On average, it takes 10 years for people to address their hearing loss.
    ô€€€
  • About one in 10 adults in the UK has mild tinnitus; up to one per cent have tinnitus that affects their quality of life.

       Source: www.actiononhearingloss.org.uk

‘In some cases, interpreters are not booked to help deaf people with important medical appointments, and they struggle. There should be more awareness of how to use interpreters and how we can be booked, so that deaf people don’t always have to reply on family or friends to tell them what’s being said.

In some cases, the client might not want a family member to be present for an appointment, if it’s a personal issue, and the worst possible scenario is that without adequate interpretation, medication may be wrongly explained.’

The issue of ‘treatment’ for deafness is something that concerns many people working
with the client group. ‘Medical professionals tend to follow the medical, and not the social model, when dealing with deaf patients, so their main emphasis is on wanting to ‘fix’ a hearing problem instead of how they can make a hearing-impaired person’s life easier.

Some people feel pushed down the route of having a cochlear implant. This isn’t always
explained properly – some people don’t realise that a cochlear implant is essentially just a very powerful hearing aid worn inside the ear.

‘Fitting an implant by necessity damages the existing nerves in their ear, which in some cases takes away any residual hearing they have. If the patient doesn’t get on with the implant and has it removed, they can even end up worse off.’

Prevention of hearing problems has been in the spotlight recently, with experts taking the opportunity to recommend hearing protection during Tinnitus Awareness Week last month.

The general advice for pharmacists is to refer anyone complaining of noises in the head and or ear/s to their GP – it could just be an easy-totreat ear infection.

If necessary, the GP can refer the patient to ENT and then onto audiology or hearing therapy department. ENT will investigate any underlying causes and audiology or hearing therapy can advise on coping strategies and management. ‘Unfortunately there is currently no cure for tinnitus,’ confirms a representative from the British Tinnitus Association, ‘but pharmacists can suggest onward referrals and can ask about side effects that patients may be experiencing.

Reassurance and directing to the BTA is a good first step to help any patient with tinnitus. ‘If people are going to be exposed to loud noise for prolonged periods, hearing protection is advisable. There are many different sorts available to suit different situations dependent on need.Pharmacists need to find out more about a person’s needs and advise accordingly.’ 

The BTA website, www.tinnitus.org.uk, and helpline, 0800 018 0527, can put customers experiencing tinnitus symptoms in touch with trained advisors, in addition to giving them details of services and support available at NHS hospitals, as well as local tinnitus support groups.

As part of National Tinnitus Awareness Week, one of Britain’s largest manufacturers of ear protection devices has partnered with the British Tinnitus Association to raise awareness of the condition and its causes. Minerva Hearing, which produces earplugs and hearing aid moulds used by the NHS and industry, is highlighting the steps young people in particular can take to protect their hearing from long-term damage.

‘We are keen to support the British Tinnitus Association in raising awareness, says marketing manager Melanie Harding. ‘As a company, we are only too aware of the debilitating effects of noiserelated hearing damage on people.’

Many people are unaware of the damage they expose their hearing to without thinking, says Ms Harding. ‘A rock concert can be louder than a pneumatic drill, but people go to gigs without any form of hearing protection. This year we will be encouraging gig-goers to wear ear plugs.’

Minerva partners with audiology departments and Specsavers. The company is also happy to provide literature to pharmacies on request.

Comment

Reena Barai, SG Barai Pharmacy, Sutton ‘Many people ask us for help with treating ear infections, but generally we are limited to what we can do. EarCalm spray is one that we will recommend. But without being able to see into the ear to check for bacterial infection, it is difficult for us to do much more. Many infections will be viral, but cases will need referral for investigation if they don’t improve. Of course, eax wax is a common problem. People may need a product to help with softening the wax, although I don’t think that many surgeries are doing ear syringing any more, or Otex is popular. We will also advise parents on issues around glue ear in children, say, if they have been needing repeat antibiotics.’

Rating: 3/5

Fiona McElrea, Whithorn Pharmacy, Whithorn ‘We prescribe a lot of products for ear problems under the minor ailments scheme, for example Cerumol, Otex and basic olive oil for ear wax build-up. Some people just tend to be more prone to ear wax problems. Parents bring in children with ear ache; we can really only offer pain relief and advise them to take the child to the GP if it could be an ear infection. You really do want someone to look into the ear. EarCalm is an option to try for adults. Ear plugs are something that we always stock, for example Ear Planes for people who have problems when flying and for people who are at risk of infections from swimming. This is a common category, but there are not that many products in it.’

Rating: 5/5

Dilip Patel, Mirage Pharmacy, Handsworth ‘The top three issues in the ear care category that present to the pharmacy are ear wax, ear ache and ringing in the ears. Otex is our primary recommendation for people with problems with ear wax. People seem to find from experience that it works well, or they have seen an advert and they decide to ask for it by name. Some people have ongoing problems, sometime resulting in deafness, but it is difficult to advise on prevention. Impaction is a problem for some too, and obviously we advise not to use ear buds or similar in the ears. Earache is difficult as it could be due to any number of conditions, although it could be down to wax or from a cold. EarCalm can be useful. But for any other issues we recommend people see the GP – ears are so delicate that we need to take care.’

Rating: 3/5

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