Personalised long-term follow-up of cochlear implant patients using remote care

Around 1,400 people receive a cochlear implant in the UK each year. These patients need a lifetime of follow-up, with regular adjustment and rehabilitation appointments in the first year and then annual follow-up appointments.

Cochlear implant care is provided at one of 19 specialist tertiary centres in the UK, which may be several hours away from the patient’s home, necessitating travel costs, time off work and family disruption.

This project from the University of Southampton Auditory Implant Service was introduced to make the care pathway more patient-centred and to provide a more efficient service.

The project involved introducing a long-term follow-up pathway for people with cochlear implants that offered them remote self-monitoring, self-adjustment of devices, and a personalised online intervention package for testing their own hearing at home.

A six month trial involved 60 people randomised to either the remote care pathway or a control group, who followed the usual care pathway. The remote care group were given tools to enable them to care for their implant and hearing at home, including a home hearing test (the 'triple digit test') on a tablet or computer, online troubleshooting and remote assistant fitting.

Trial results from a disease specific empowerment questionnaire showed a significant increase in how empowered patients in the remote care group were to look after their own hearing and maintain their devices. Triple digit test results improved in the remote care group, although results from self-assessment hearing ability questionnaires revealed that patients had not noticed a change (whereas the control group felt their hearing had become slightly worse). Quality of life remained unchanged in both groups.

Challenges included some patients having difficulty connecting to resources at home or logging on, which was helped with the production of a frequently asked questions document. The intervention has embedded well within the clinical service in Southampton, and there is wider clinical interest in the project and the potential to offer remote care in the future.

This Innovating for Improvement project ran from the beginning of May 2015 until the end of July 2016.

Downloads

• Video: New cochlear implant clinical trial at University of Southampton
• BMJ Open: ‘Personalised long-term follow-up of cochlear implant patients using remote care, compared with those on the standard care pathway: study protocol for a feasibility randomised controlled trial’

Contact information

For more information about this project, please contact Dr Helen Cullington, Clinical Scientist (Audiology), University of Southampton Auditory Implant Service.