Telemedicine for adults with cochlear implants in the UK (CHOICE): protocol for a prospective interventional multi-site study (Preprint)

BACKGROUND:Cochlear implants provide hearing to around 750,000 people with deafness worldwide; patients require lifelong follow-up. Care for adults with implants in the UK occurs at one of 19 centres, which may be far from the patient's home. In a previous RCT, we successfully introduced person-centred care. We designed, implemented and evaluated a remote care pathway: a personalised online support tool, home hearing check, self device adjustment, and upgrading of sound processors at home rather than in clinic. The remote care group had a significant increase in empowerment after using the tools; patients and clinicians were keen to continue. We would now like to scale up these improvements as an option to the more than 12,000 UK adults using implants; we are commissioning an independent evaluation of this intervention and roll out to establish if it achieves its aims of more empowered and confident patients; more accessible and equitable care; stable hearing; more efficient, person-centred and scalable service; more satisfied and engaged patients and clinicians.OBJECTIVE:To evaluate the impact and roll out of a person-centred clinical care pathway via telemedicine for adults with cochlear implants in the UK, using both outcomes and process evaluation.METHODS:This project will scale up and evaluate a person-centred long-term follow-up pathway for adults using cochlear implants using a personalised website including a home hearing check, upload of photos of cochlear implant site, listening in noise and music practice, spares ordering, questionnaires, and other resources. Both quantitative and qualitative analyses will occur, and it will be both an outcomes and process evaluation.RESULTS:As of July 2021, the trial is closed, and all data collection is complete. The evaluation report is expected to be published in December 2021; the research data have not been analysed yet.CONCLUSIONS:This project will present results of the first scaling up of a remote care pathway for adults with cochlear implants in the UK