Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-23T23:49:13.241Z Has data issue: false hasContentIssue false
  • English
  • Français

Cochlear implant eligibility in an adult hearing aid population: a multi-perspective service evaluation of a patient referral pathway at a British district general hospital

Published online by Cambridge University Press:  10 January 2022

L Thompson ,
H Z Bazeer ,
B Young ,
G Smith ,
J Blackaby ,
J Wasson  and
A Trinidade Open the ORCID record for A Trinidade [Opens in a new window]
L Thompson
Affiliation:
Anglia Ruskin University Medical School, Chelmsford, UK
H Z Bazeer
Affiliation:
Department of Otolaryngology, Southend University Hospital NHS Foundation Trust, UK
B Young
Affiliation:
Anglia Ruskin University Medical School, Chelmsford, UK
G Smith
Affiliation:
Department of Audiology, Southend University Hospital NHS Foundation Trust, UK
J Blackaby
Affiliation:
Department of Audiology, Southend University Hospital NHS Foundation Trust, UK
J Wasson
Affiliation:
Department of Otolaryngology, East Kent University Hospitals NHS Foundation Trust, Canterbury, UK
A Trinidade*
Affiliation:
Anglia Ruskin University Medical School, Chelmsford, UK Department of Otolaryngology, Southend University Hospital NHS Foundation Trust, UK
*
Author for correspondence: Mr A Trinidade, Department of Otolaryngology, Southend University Hospital, Prittlewell Chase, Southend-on-SeaSS0 0RY, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

To quantify patient eligibility for cochlear implantation following National Institute for Health and Care Excellence 2019 guidelines (TA566) over five years at our institution, and identify factors influencing patients’ decisions surrounding cochlear implantation referral.

Methods

A multi-perspective service evaluation was conducted at a district general hospital, comprising cochlear implantation eligible patients. The main outcome measures were: eligibility numbers for 2014–2019, comparing application of TA566 versus 2009 (TA166) guidelines; and patient interview transcripts and questionnaires.

Results

There was a 259 per cent average increase in cochlear implantation eligibility from 2014 to 2019. Most patients’ thresholds were 80 dB HL or more at 3 kHz and 4 kHz. There are several cochlear implantation barriers, including patient-centred issues (e.g. health-related anxieties, implantation misperceptions) and external barriers (difficulty getting to regional implant centres). Motivating factors for cochlear implantation include improved quality of life and access to local cochlear implantation services.

Conclusion

The TA566 guidelines have increased cochlear implantation eligibility, putting pressure on cochlear implantation centres and referring hospitals. Current referral systems have external and patient-centred implantation barriers. British cochlear implantation delivery may need rethinking to meet increasing populational demands and improve accessibility for those most vulnerable to these barriers.

Keywords

Cochlear ImplantsEligibility DeterminationSelection CriteriaHealth Services Evaluation
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 8 , August 2022 , pp. 755 - 759
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Mr A Trinidade takes responsibility for the integrity of the content of the paper

References

National Institute for Health and Care Excellence. Cochlear implants for children and adults with severe to profound deafness. Technology appraisal guidance [TA566]. In: https://www.nice.org.uk/guidance/TA566/chapter/1-Recommendations [29 March 2020]Google Scholar
National Institute for Health and Care Excellence. 890 more children and adults eligible for cochlear implants on the NHS each year. In: https://www.nice.org.uk/news/article/hundreds-more-children-and-adults-eligible-for-cochlear-implants-on-the-nhs [9 June 2020]Google Scholar
British Cochlear Implant Group. BCIG Annual Data Collection Financial Year 2018-2019. In: https://www.bcig.org.uk/wp-content/uploads/2020/02/BCIG-activity-data-FY18-19.pdf [9 June 2020]Google Scholar
Grounds, R, Miachi, E, Beckham, T, Neumann, C, Wasson, J. How many patients will be eligible for cochlear implantation (CI) on audiological grounds, once the new 2019 NICE guidance takes effect? Evaluation of audiological data for the population of East Kent to estimate cochlear implantation eligibility based on NICE 2019 guidance (TA566) and NICE 2009 guidance (TA166). Clin Otolaryngol 2020;45:932–710.1111/coa.13605CrossRefGoogle Scholar
Bierbaum, M, McMahon, CM, Hughes, S, Boisvert, I, Lau, AYS, Braithwaite, J et al. Barriers and facilitators to cochlear implant uptake in Australia and the United Kingdom. Ear Hear 2020;41:374–85CrossRefGoogle ScholarPubMed
Rapport, F, Hughes, SE, Boisvert, I, McMahon, CM, Braithwaite, J, Faris, M et al. Adults’ cochlear implant journeys through care: a qualitative study. BMC Health Serv Res 2020;20:45710.1186/s12913-020-05334-yCrossRefGoogle ScholarPubMed
British Cochlear Implant Group. Quality Standards: Cochlear Implant Services for Children and Adults. In: https://www.bcig.org.uk/wp-content/uploads/2018/05/QS-update-2018-PDF-final.pdf [23 February 2021]Google Scholar
Oussedik, S, MacIntyre, S, Gray, J, McMeekin, P, Clement, ND, Deehan, DJ. Elective orthopaedic cancellations due to the COVID-19 pandemic: where are we now, and where are we heading? Bone Jt Open 2021;2:103–1010.1302/2633-1462.22.BJO-2020-0161.R1CrossRefGoogle Scholar
The King's Fund. ‘The impact of Covid-19 on waiting times for NHS patients will be felt for years to come’: The King's Fund responds to latest NHS performance statistics. In: https://www.kingsfund.org.uk/press/press-releases/impact-covid-19-waiting-times-NHS-patients [23 February 2021]Google Scholar
Livingston, G, Huntley, J, Sommerlad, A, Ames, D, Ballard, C, Banerjee, S et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020;396:413–4610.1016/S0140-6736(20)30367-6CrossRefGoogle ScholarPubMed