Reduced Aftercare Treatment Schedule for Cochlear Implantation Is Efficient and Effective

by Linda Kossoff •

What is the effect on clinic efficiency of an evidence-based model (EBM) approach to cochlear implant (CI) aftercare in patients’ first year post-surgery?

BOTTOM LINE

A four-appointment EBM approach delivered efficient and effective audiological aftercare to CI recipients in the first year following CI implantation.

BACKGROUND: CIs are an intervention that is increasingly used for moderate-to-profound sensorineural hearing loss. Although American Academy of Audiology guidelines call for six to eight aftercare appointments, this criterion can strain in-clinic resources and pose hardships for recipients. There is currently no universal, standardized approach to CI patients’ postoperative care.

STUDY DESIGN: Prospective proof-of-concept study.

SETTING: Michigan Ear Institute, Farmington Hills, Mich.

SYNOPSIS: Researchers implemented a modified, reduced treatment schedule for newly implanted CI recipients involving only four clinic visits (at initial activation, and one-month, three-month, and six-month postactivation), as part of an assessment of an outcomes-driven, computer-assisted approach to CI fitting. The primary objective was to assess the EBM approach’s effect on clinic efficiency. A secondary objective was to assess the model’s impact on patient outcomes. Across three clinics, a total of 17 newly implanted adult patients with postlingual hearing loss were enrolled. Hearing outcomes were measured using objective speech testing and subjective self-report measures. Most recipients (82%) were able to follow the four-appointment schedule, translating into an average time savings of three hours per patient, enough to enable clinics to increase their patient capacity using the same staff resources. Significant improvements in speech perception were observed at three and six months postactivation, and recipients were significantly satisfied with telephone, music, small group conversation, and television listening at the six-month mark. Overall service was rated as “excellent” by all respondents. Study limitations included the lack of a formal control group.

CITATION: Porps SL, Bennett DM, Gilden J, et al. Effects of an evidence-based model for cochlear implant aftercare delivery on clinical efficiency and patient outcomes [published online March 16, 2023] Cochlear Implants Int.