It started with a phone call. A conversation to gauge interest in a collaborative project between Professor Elaine Mormer, Department of Communication Science and Disorders (CSD), and Associate Professor Lucas A. Berenbrok, Pitt School of Pharmacy.
The result: a world-class interprofessional education model that has garnered national attention. And promises to change the lives of individuals with perceived mild to moderate hearing loss who might benefit from over-the-counter (OTC) hearing devices.
Recognizing the Need
OTC hearing devices were a long time coming. Authorized by the U.S. Food and Drug Administration Reauthorization Act back in 2017, people are beginning to purchase them at community pharmacies across the country.
“This is a huge change in the distribution channels for hearing aids,” says Mormer. “Instead of patients with mild to moderate hearing loss going to their primary care doctor, then being referred to an ear doctor or audiologist, they would have the opportunity to get immediate hearing help at their neighborhood pharmacy.
Hearing loss is the third most chronic condition in older adults.
“Although we knew it would take time before these products were on pharmacy shelves, we had an idea,” explains Mormer.
She and Berenbrok reasoned that pharmacists would consider OTC hearing aids similar to other OTC self-care health solutions routinely sold at pharmacies, such as reading glasses and certain durable medical equipment.
The only problem: Someone needed to educate pharmacists on how they could best provide safe and effective guidance on hearing devices to their customers.
Enter the CHAMP program.
With a modest grant from the Provost’s Innovation in Education Award, Mormer and Berenbrok went to work designing CHAMP (Championing Hearing using Accessible Medication experts at the community Pharmacy). It’s a 2.5-hour online continuing education program for pharmacists.
In addition to practitioner training, CHAMP offers the first OTC hearing aid microcredential for student pharmacists which teaches the core competencies needed for assisting patients with OTC hearing devices.
“CHAMP is unique in that it is the first and only training program for pharmacists to learn about OTC hearing aids.”
Lucas Berenbrok
“Our program was designed by Elaine, an audiologist, and me, a pharmacist, to specifically address hearing health care and the opportunity for interprofessional collaboration between our two fields.”
CHAMP is built on a competency framework developed by an expert panel of stakeholders.
“We were convinced this was a bold and much-needed strategy, but we wanted to combine our own expertise in audiology and pharmacy with key players in the industry and patient community,” notes Mormer.
The panel of diverse stakeholders was essential to the process. They included the American Pharmacists Association, National Association of Chain Drug Stores, American Association of Colleges of Pharmacy, American Academy of Audiology, American Speech-LanguageHearing Association, Hearing Loss Association of America and representatives from two hearing device manufacturers as well as patients with hearing loss.
Mormer says they used the Delphi method research approach to form a consensus on what pharmacists needed to know in order to help patients.
Nearly 30 million adults in the United States could benefit from hearing aids.
After a year of listening and analyzing, the team identified 26 competencies for pharmacists, including how to recognize signs of hearing loss and assist patients in the selection of hearing devices by considering the individual’s needs and preferences. They saw the need to teach pharmacists how to effectively communicate with people with hearing loss and to make referrals to local audiologists when appropriate.
By 2019, the Pitt team had garnered additional funding from the Pitt Innovation Institute’s First Gear program and were ready to develop the online education program.
Doing What No One Else Has Done
While much of the world was on pause for the global pandemic, Mormer and Berenbrok worked with an instructional designer to launch an engaging online course. Among other topics in the course, pharmacists learn about different types and degrees of hearing loss, and the differences between professionally fit and OTC hearing aid devices. Overall, the course is focused on integrating OTC hearing aids into the existing patient care process that pharmacists use to take care of their patients.
90% of Americans live within close proximity to 60,000 community pharmacies.
They continued to engage in partnerships that would help promote their online course.
For example, the American Speech-Language-Hearing Association (ASHA) created a toolkit for audiologists to view OTC devices with an interprofessional lens. The CHAMP course is linked in the toolkit for audiologists to share with pharmacy colleagues.
They also received a grant from the American Academy of Audiology (AAA) to create EAR SCANS, a QR code magnet that sticks to the pharmacy refrigerator. The magnet acts as a visual resource for pharmacy personnel to review when assessing a patient’s candidacy for OTC hearing aid devices
When pharmacists scan the QR code, they immediately see red-flag conditions that contraindicate OTC hearing aid use as well as contact information for referrals to local audiologists.
Magnets were distributed in 2022 at the American Pharmacists Association Annual Meeting in San Antonio, Texas, the American Academy of Audiology convention in St. Louis and the Pennsylvania Speech Language-Hearing Association annual meeting in Pittsburgh.
Currently, less than 20% of people who could benefit from hearing aids actually use them.
The EAR SCANS magnets were a huge success. “They are a great way for audiologists to engage with pharmacists,” says Mormer. “We continue to receive delivery requests from audiologists, many of whom are asking to have their supply replenished after distribution to multiple pharmacies.”
Although OTC devices may not be seen in community pharmacies until late in 2022, pharmacists and audiologists are connecting with each other, and pharmacists are taking the CHAMP course online.
“Through our work, Elaine and I have been able to connect the professions of pharmacy and audiology in brand new ways,” reports Berenbrok. “We really take pride in showing pharmacists how important audiologists are to patients and to their health care teams, and vice versa. I feel immense pride every time a pharmacist and audiologist connect to talk about OTC hearing aids.”
Not Their First Collaboration
In 2017, Mormer and her AuD students joined Berenbrok and his PharmD students to learn more about SilverScripts, an award-winning program from Pitt Pharmacy to help seniors better manage their medications. The goal was to work together to address the medication and hearing-related needs of older adults at local community senior centers.
As a result, Mormer invited Assistant Professor Nicole Corbin to develop a parallel program in CSD as part of her clinical teaching responsibilities. In fall 2019, Corbin launched SilverSounds, a hearing health care service that includes hearing assessments, hearing assistance technology and basic checks of hearing device function. It is offered free of charge at community health centers, including the Pitt Community Engagement Center in Homewood, and serves as a clinical experience for first-year Doctor of Audiology students.
“Collaborations such as these between audiology and pharmacy break down our professional silos and meet the patient where they are in their communities,” observes Corbin. “By doing this, we increase accessibility to care for individuals from varied backgrounds.
“By modeling collaboration at this level, we show that interprofessional practice is both feasible and effective.”
