Cochlear implant care: putting patients in charge

Cochlear implant care: putting patients in charge Aim To design, implement and evaluate a person-centred long-term follow-up pathway for adults with cochlear implants offering: • home hearing test on iPad or computer (Digit Triplet Test) • online support tool for troubleshooting, rehab, info etc. • upgraded processor sent to home instead of clinic visit (if upgrade due) • self-mapping for some people Method This was a two-arm feasibility Randomised Controlled Trial involving 60 adults using cochlear implants with at least 6 months device experience in a 6 month clinical trial of remote care. The control group followed their usual care pathway. The remote care group were given tools to care for their implant and hearing at home. The main outcome evaluated was patient empowerment. Secondary outcomes were hearing, quality of life, and subjective feedback from patients and clinicians. Results The remote care group had a significant increase in their cochlear implant empowerment after using the remote care tools. Quality of life remained unchanged in the two groups. The hearing test result had improved in the remote care group, although they had not noticed a change. The control group, however, felt their hearing had become slightly worse. Subjective feedback was positive with most patients finding the home hearing test the most valuable tool. Conclusion and plans for spread Offering remote follow-up may result in more empowered patients; more stable hearing; reduced patient travel expense, time and disruption; greater equality in service delivery and more freedom to optimise the allocation of clinic resources. At the University of Southampton Auditory Implant Service, some aspects of remote care are now offered to adults as part of personalised stratified care, with a full roll out planned by the end of 2017