Andersson 1994.

Methods	Randomised
Participants	N = 20 Age: range 64 to 72 11 male, 9 female "Recently" retired, existing HA users (mean duration 2.8 years)
Interventions	HA alone versus HA + AR AR: 60‐minute behavioural counselling session over 3 consecutive weeks with homework tasks ‐ could be group, individual or combined depending on functional analysis and practical considerations
Outcomes	Short‐term: baseline and 4 weeks later (post AR) ‐ Life Orientation Test (PSYCHOLOGICAL/OPTIMISM) Long‐term: 15 months post‐intervention ‐ Hearing Coping Assessment (HANDICAP/DISABILITY)
Notes	Could not include Hearing Questionnaire developed by the authors for this study and post‐counselling questions also developed for this study Have included Hearing Coping Assessment as it was separately validated (although by the same authors)
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Quote: "subjects were randomly assigned to one of two groups" Comment: no details of randomisation process given
Allocation concealment (selection bias)	Unclear risk	Comment: no details of randomisation process
Blinding of participants and personnel (performance bias) All outcomes	High risk	Comment: not blinded due to the nature of the intervention
Blinding of outcome assessment (detection bias) All outcomes	High risk	Comment: authors comment in discussion on the potential effect on non‐blinding
Incomplete outcome data (attrition bias) All outcomes	Low risk	Comment: 1 patient in the intervention group not reached at long‐term FU – not clear whether results for long‐term FU analysed on an intention‐to‐treat basis but only 1 patient lost
Selective reporting (reporting bias)	High risk	Comment: no protocol available Also, in a later 1998 paper they describe how HA use was measured in this study but not reported
Other bias	Unclear risk	2 of the outcome measures in the study could not be used as they were developed specifically for this study by the authors