Adult cochlear implant (CI) recipients are known to require several hours of “face time” with an audiologist following surgical intervention. In addition to mapping the CI, audiologists spend a considerable amount of time on CI orientation, review of CI accessories and other important counseling-related activities.
Unquestionably, these are vital components of follow-up care that lead to successful CI outcomes. Taking time off of work, finding a ride to the clinic and managing a busy schedule with several assorted follow-up appointments, however, can be terribly inconvenient for the patient, and lead to missed appointments, which, in turn, can lead to poorer than expected outcomes.
Telehealth and Cochlear Implant Users
A recent study shows that adult CI recipients who receive postoperative care via a remote, telemedicine service have a significant increase in their empowerment, and, in addition, demonstrate substantial improvements in their hearing ability after using the online tools.
Audiologists at the University of Southampton Auditory Implant Service in the UK, followed 60 adults who had used cochlear implants for at least 6 months. In their randomized controlled trial, one-half of the study participants served as the control group and followed the usual CI follow-up care pathway.
The other half of the study participants received care remotely for six months. The telehealth service gave the remote care group (n=30) access to self-adjustment of their CI devices as well as a personalized online intervention package for testing their own hearing with access to rehabilitation, troubleshooting and training at home.
Results of the study showed that remote care for long-term follow-up is feasible and acceptable, leading to more empowered patients. Specifically, the remote care group had a greater increase in patient activation and was more likely to be more actively involved in hearing testing compared to the control group. The remote care group improved on the Triple Digit Test hearing test, whereas the control group perceived their hearing was worse on the Speech, Spatial and Qualities of Hearing Scale questionnaire. Quality of life remained unchanged in both groups. Additionally, patients and clinicians were generally positive about remote care tools and wanted to continue.
According to Helen Cullington, lead author of the paper published in BMJ Open, “We found that only the remote care group had a significant increase in their cochlear implant empowerment after using the remote care tools. Quality of life remained stable in the two groups during the randomized trial. The hearing test result in clinic, however, had improved in the remote care group; this may suggest that the remote care group were more able to take action to keep their hearing stable during the trial. Patients and clinicians were generally keen to continue remote care, with the most popular aspect being the home hearing test.” Dr. Cullington was interviewed by Medicalxpress, where these quotes first appeared.
Given the low rates of CI uptake, particularly among older adults with severe to profound hearing loss, coupled with expanding CI criteria, remote testing and follow-up care delivered via telehealth could lead to greater utilization and improved outcomes for individuals who chose CI intervention. Results of this BMJ Open study are in alignment with the digital health trends discussed by De Wet Swanepoel in this recent AO interview.
*Featured image courtesy USH