Effects of an evidence-based model for cochlear implant aftercare delivery on clinical efficiency and patient outcomes

Abstract

Objectives

To assess an evidence-based model (EBM) approach to cochlear implant (CI) aftercare that includes a modified, reduced treatment schedule for newly-implanted adult CI recipients consisting of four appointments (initial activation, 1-, 3- and 6- months postactivation) in the first year post-surgery.

Method

This prospective multicenter proof-of-concept study was conducted across three clinics in the United States by five experienced CI clinicians. Seventeen newly-implanted adult patients with postlingual hearing loss enrolled in the study. Hearing outcomes were measured using objective speech testing and subjective self-report measures.

Results

Most recipients (14/17; 82%) were able to follow the four-appointment EBM schedule. The reduced number of visits translated into an average time savings of 3 hours per patient. Significant improvements in speech perception were observed at both 3- and 6-months postactivation, as measured by CNC words in quiet and AzBio sentences at +10 dB SNR, consistent with published results achieved by traditional practices. Recipients were significantly satisfied with telephone, music, small group conversation, and television listening at 6 months postactivation. Recipient satisfaction with overall service was rated as ”excellent” by 14/14 (100%) respondents.

Conclusion

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

Keywords:

• Cochlear implant
• Postoperative
• Care
• Evidence
• Efficiency
• Satisfaction
• Visits

Acknowledgements

The authors would like to thank the patients and support staff in each clinic for their participation in this study. We would also like to thank Beejal Vyas-Price and Josie Wyss (Cochlear Ltd) for medical writing support.

Disclaimer statements

Contributors SP contributed to the study design, patient evaluation, data analyses, manuscript development and review; DMB contributed to the study design, patient evaluation, data analyses and manuscript review; JG contributed to the study design, patient evaluation, data analyses and manuscript review; KR contributed to the study design, patient evaluation, data analyses and manuscript review; BB contributed to the study design, data analyses and manuscript development and review; PR contributed to data analyses and manuscript development and review; RSH contributed to the study design, patient evaluation, data analyses, manuscript development and review

Funding This work was supported by Cochlear Americas, CO, United States.

Conflicts of interest No potential conflict of interest was reported by the author(s).

Ethics approval WIC IRB CAM-SOC-EBM01-2020337.