C2Hear: Multimedia educational package improves the lives of first-time hearing-aid users

C2Hear: Multimedia educational package improves the lives of first-time hearing-aid users

The Nottingham Biomedical Research Centre (BRC) hearing theme has created Reusable Learning Objects (videos/ DVDs) providing advice and information to help people to cope with using hearing aids.

A participatory approach led to the development of C2Hear, influenced by members of the public and hearing-aid users. Randomised Control Trial (RCT) evaluation of efficacy showed improved knowledge, practical skills, hearing-aid use and self-confidence.

Health economic analysis showed C2Hear to be a cost-effective clinical intervention. This has led to license agreement between the partnership between Nottingham University Hospitals NHS Trust, the University of Nottingham, commercial sector partner, PC Werth Ltd, and the charity Action on Hearing Loss, with the C2Hear trade mark registered.

Impact on NHS models of care

The C2Hear DVD is available through the NHS Supply Framework. The online videos are freely available. A local NHS Clinical Commissioning Group is funding the DVD for new hearing-aid users and take-up is 90%. Five leading UK audiology departments are implementation models for C2Hear and increasing numbers of audiology departments are using C2Hear in clinic for patients and in waiting rooms.

C2Hear videos are hosted on all the key hearing charity websites: Action on Hearing Loss, Hearing Link, Ear Foundation, National Community Hearing Association, and are recommended in the revised BSA practice guidance for adult rehabilitation services. 35% of views are outside the UK, indicating international interest.

International development

We are working with requests to translate into other languages (French, Danish, Hebrew, US-English) with interest from the World Health Organisation for non-English speaking countries and the EM-CLAHRC Centre for Black and Minority Ethnic Health. C2Hear is part of a clinical trial of adult rehabilitation (ACHIEVE-P, NCT02412254) led by John Hopkins University, Baltimore, USA.

Improving the societal relevance of research by prioritising questions that are most important for patients and clinicians

The Nottingham BRC hearing theme led on two of the three James Lind Alliance Priority Setting Partnerships (PSP) in ENT and Audiology, which cover two of the most prevalent and burdensome conditions affecting adults in the UK: Tinnitus (2013) and Mild-to-moderate Sensorineural Hearing Loss (2015).

By identifying the ‘top 10’ list of unanswered treatment and research priorities, these JLA PSPs have influenced:

  • prioritisation of new systematic reviews of amplification for tinnitus and for hearing loss by the Cochrane ENT group
  • the NIHR Horizon Scanning Research and Intelligence Centre is to run a global search to identify emerging technologies to benefit people with mild-moderate hearing loss
  • BSA Practice Guidance for Tinnitus in Children and Teenagers and for Rehabilitation of adults with hearing loss
  • A pan- European working group (Core Outcome Measures in Tinnitus, COMiT, initiative) supported by an EU COST Action and chaired by Hoare is producing a Core Outcome Set to create standards for selecting patient-reported outcome measures (PROMs) in a range of clinical trials of treatment efficacy
  • validation of a US-developed patient-reported outcome measure for tinnitus with recommendations to UK audiologists for modifications of its use.