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Cochlear implant referral patterns in the UK suggest a postcode lottery with inequitable access for older adults; results of a pilot audit in five Audiology sites

Cochlear implant referral patterns in the UK suggest a postcode lottery with inequitable access for older adults; results of a pilot audit in five Audiology sites
Cochlear implant referral patterns in the UK suggest a postcode lottery with inequitable access for older adults; results of a pilot audit in five Audiology sites
Objective: to use a standardised reporting tool to identify potential eligible candidates for cochlear implant (CI) referral and quantify the proportion of adults who had a CI referral discussion after presenting with an audiogram within United Kingdom (UK) audiometric criteria.

Design: retrospective multicentre 6-month audit of Audiology clinic databases.

Study sample: a total of 810 adults from five geographically diverse UK Audiology sites.

Results: data were collected in late 2019 after UK CI audiometric candidacy criteria changed; one site collected only 3 months of data. The proportion of potential eligible adults (based only on audiometry) considered for CI referral was 64% (521 out of 810) and varied by site (from 50% to 83%). About 24% of patients (123 out of 521) declined CI referral; this also varied across sites (12–45%). The median age of patients where CI referral was not considered was 80 years – significantly higher than the group where CI referral was considered (73 years).

Conclusions: CI referral is dependent on where adults live, and how old they are. Older adults are significantly less likely to be considered for CI referral by Audiologists. Audiology clinics need more support to empower staff to talk to patients about CI referral.
Audiology, Cochlear implant, audit, referral, severe to profound deafness
1499-2027
Cullington, Helen
a8b72e6d-2788-406d-aefe-d7f34ee6e10e
Dickinson, Ann-Marie
a7ee2161-ab27-4f6e-8533-af8086a4498d
de Estibariz, Unai Martinez
a5d1a7a7-87b3-4b9a-ae8b-0c9ef0c96fb7
Blackaby, Joseph
f985bfb9-b028-4a46-834f-3013d580994d
Kennedy, Lisa
1dbc363f-9dad-450a-9ff0-ed70b251a3fa
McNeill, Katie
6fda1cb9-631c-48ca-8abe-d0c49731c4df
O’Neill, Sara
ce79fcb6-9e83-4d20-bd2f-707d8b3ea9d9
Cullington, Helen
a8b72e6d-2788-406d-aefe-d7f34ee6e10e
Dickinson, Ann-Marie
a7ee2161-ab27-4f6e-8533-af8086a4498d
de Estibariz, Unai Martinez
a5d1a7a7-87b3-4b9a-ae8b-0c9ef0c96fb7
Blackaby, Joseph
f985bfb9-b028-4a46-834f-3013d580994d
Kennedy, Lisa
1dbc363f-9dad-450a-9ff0-ed70b251a3fa
McNeill, Katie
6fda1cb9-631c-48ca-8abe-d0c49731c4df
O’Neill, Sara
ce79fcb6-9e83-4d20-bd2f-707d8b3ea9d9

Cullington, Helen, Dickinson, Ann-Marie, de Estibariz, Unai Martinez, Blackaby, Joseph, Kennedy, Lisa, McNeill, Katie and O’Neill, Sara (2024) Cochlear implant referral patterns in the UK suggest a postcode lottery with inequitable access for older adults; results of a pilot audit in five Audiology sites. International Journal of Audiology. (doi:10.1080/14992027.2023.2298751).

Record type: Article

Abstract

Objective: to use a standardised reporting tool to identify potential eligible candidates for cochlear implant (CI) referral and quantify the proportion of adults who had a CI referral discussion after presenting with an audiogram within United Kingdom (UK) audiometric criteria.

Design: retrospective multicentre 6-month audit of Audiology clinic databases.

Study sample: a total of 810 adults from five geographically diverse UK Audiology sites.

Results: data were collected in late 2019 after UK CI audiometric candidacy criteria changed; one site collected only 3 months of data. The proportion of potential eligible adults (based only on audiometry) considered for CI referral was 64% (521 out of 810) and varied by site (from 50% to 83%). About 24% of patients (123 out of 521) declined CI referral; this also varied across sites (12–45%). The median age of patients where CI referral was not considered was 80 years – significantly higher than the group where CI referral was considered (73 years).

Conclusions: CI referral is dependent on where adults live, and how old they are. Older adults are significantly less likely to be considered for CI referral by Audiologists. Audiology clinics need more support to empower staff to talk to patients about CI referral.

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IJA paper 2023 accepted version - Accepted Manuscript
Restricted to Repository staff only until 27 January 2025.
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Accepted/In Press date: 21 December 2023
e-pub ahead of print date: 27 January 2024
Published date: 27 January 2024
Additional Information: Publisher Copyright: © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on behalf of British Society of Audiology, International Society of Audiology, and Nordic Audiological Society.
Keywords: Audiology, Cochlear implant, audit, referral, severe to profound deafness

Identifiers

Local EPrints ID: 485985
URI: http://eprints.soton.ac.uk/id/eprint/485985
ISSN: 1499-2027
PURE UUID: dc6676be-a9fb-4936-a24a-af4063258341
ORCID for Helen Cullington: ORCID iD orcid.org/0000-0002-5093-2020

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Date deposited: 04 Jan 2024 18:55
Last modified: 24 Apr 2024 01:41

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Contributors

Author: Ann-Marie Dickinson
Author: Unai Martinez de Estibariz
Author: Joseph Blackaby
Author: Lisa Kennedy
Author: Katie McNeill
Author: Sara O’Neill

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