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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: aaron.trinidade@nhs.net
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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

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Footnotes

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

References

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