Ototoxicity monitoring through the eyes of the treating physician: Perspectives from pulmonology and medical oncology

Abstract

Objectives: Integrating audiological management into the care pathways of clinical specialties that prescribe ototoxic medications for essential, often life-preserving medical care that is critical for early hearing loss identification and remediation. Research shows that successful implementation of a new health service or intervention requires alignment of goals among provider groups, institutional leadership and patients. Thoughtful consideration of the physician’s viewpoints about ototoxicity and its implications for treatment planning is, therefore, important for the implementation and enduring success of an ototoxicity monitoring programme (OMP). Design: This discussion paper uses qualitative methods to explore the perspectives of four physicians on OMP provision in their patient populations. Study sample: Three pulmonologists and one oncologist completed the written survey or survey-based interview described in this report. Results: Each physician indicated that (i) ototoxicity is a potential problem for their patients; (ii) monitoring hearing is important to ensure good quality of life among their patients and (iii) treatment modification would be considered if an alternative treatment option were available. The physicians differed in their approaches to ototoxicity monitoring, from routine referrals to audiology, to relying on patient self-referral. Conclusion: Physician provider input is needed to optimise monitoring schedules and OMP care coordination with audiology.

Key Words:

• Ototoxicity monitoring
• medical audiology
• adult or general hearing screening
• pulmonology
• oncology
• chemotherapy
• cisplatin
• aminoglycoside

Acknowledgements

Funding for this work was partially provided DKM by the U.S. Department of Veterans Affairs Office of Rehabilitation Research & Development (RR&D) Service (Grant #C0239R). This research was supported in part (KF) by the Intramural Research Program of the NIH, National Heart, Lung and Blood Institute, and in part (ACG) by the National Institute on Deafness and other Communication Disorders (NIDCD) of the NIH under (award number R01DC10202).. We thank Dr. Marilyn Dille for allowing us to adapt her survey for use here and Dr. Carmen Brewer for interviewing the pulmonary care specialist (KPF). Dr. Maggiore was at Oregon Health & Science University and VA Portland Health Care System during the interview and transitioned to University of Rochester, Rochester, NY during the writing and editing phase of this manuscript. The opinions and assertions presented are the private views of the authors and are not to be construed as official or as necessarily reflecting the views of the Department of Veterans Affairs or the US Government.

Declaration of interest

Dawn Konrad-Martin is listed as a co-inventor on patents for a hearing test and mobile device. These patents generate no revenue. No other potential conflicts of interest were reported by the authors.

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