A randomised controlled feasibility trial of an Active Communication Education programme plus hearing aid provision versus hearing aid provision alone (ACE To HEAR)

Objective: To establish the acceptability and feasibility of delivering the Active Communication Education (ACE) programme to increase quality-of-life through improving communication and hearing aid use in the UK National Health Service. Design: Randomised controlled, open feasibility trial with embedded economic and process evaluations. Setting: Audiology Departments in two hospitals in two UK cities. Participants: Twelve hearing aid users aged 18 years or over who reported moderate or less than moderate benefit from their new hearing aid. Interventions: Consenting participants (along with a significant other) were to be randomised by a remote, centralised randomisation service in groups to Active Communication Education (ACE) plus treatment-as-usual (intervention group) or treatment-as-usual only (control group). Primary outcome measures: The primary outcomes were related to feasibility: recruitment, retention, treatment adherence and acceptability to participants, and fidelity of treatment delivery. Secondary outcome measures: International Outcomes Inventory for Hearing Aids, Self-Assessment of Communication, EQ-5D-5L and Short-Form 36. Blinding of the participants and facilitator was not possible. Results: Twelve hearing aid users and six significant others consented to take part. Eight hearing aid users were randomised: four to the intervention group; and four to treatment-as-usual only. Four significant others participated alongside the randomised participants. Recruitment to the study was very low and centres only screened 466 hearing aid users over the 15-month recruitment period, compared with the approximately 3,500 anticipated. Only one ACE group and one control group were formed. ACE could be delivered and appeared acceptable to participants. We were unable to robustly assess attrition and attendance rates due to the low sample size. Conclusions: Whilst ACE appeared acceptable to hearing aid users and feasible to deliver, it was not feasible to identify and recruit participants struggling with their hearing aids at the 3-month post-hearing aid fitting point. Trial registration: ISRCTN28090877