Effectiveness of aftercare for older people prescribed a hearing aid for the first time.

The evidence of the effects of various aspects of the organisation of hearing aid services are reviewed. It is concluded that evidence is becoming available of the importance of the range of aids in determining level of use achieved by patients. However little is known about the effects of aftercare. Two different forms of aftercare service are compared, one of which provided a routine visit at two weeks to a sample of first-time hearing aid users and the other of which provided help only to those who sought it by returning to the hospital. The patients who had the former service showed significantly higher levels of use of their hearing aids compared with the latter group. This data also confirmed that the new National Health Service (NHS) BE10 series aids are used substantially more than was the body worn OL56 and irrespective of aftercare. Implications for the organisation of services are that a first essential is an acceptable range of hearing aids. Secondly, it is essential that the fitting, care and use of the aids are effectively taught. Finally the organisation of aftercare should be such that the patients' performance is monitored against specific criteria in an on-going fashion using senior staff economically to deal with the most difficult patients.