Quality Care 2019: Hearing Screening After Treatment for Head and Neck Cancers
Posted: Tuesday, September 10, 2019
Patients with head and neck cancers treated with cisplatin and/or radiation therapy may be at risk for ototoxicity. Clinicians support formal hearing exams after treatment to allow for early detection, but many barriers to screening exist. Priya Bapat, PhD, of the Princess Margaret Cancer Centre in Toronto, and colleagues presented their findings at the 2019 American Society of Clinical Oncology (ASCO) Quality Care Symposium in San Diego (Abstract 127).
The team surveyed a multitude of specialists including physicians, nurses, coordinators, and audiologists (stakeholders) to identify both barriers to and ways to facilitate hearing screening tests for this patient population. The results of the survey showed that all patients received baseline hearing tests, but follow-up testing after cisplatin and/or radiation treatment is inconsistently performed in asymptomatic patients. Therefore, the stakeholders identified formalized follow-up as the best approach to ensure all patients are screened.
Several barriers to implementing formalized follow-up were identified; they include limited knowledge about intervals for hearing testing and a lack of time during clinic visits. At the institutional level, a lack of personnel, financial resources, and logistical supports added additional complications. Patients faced their own barriers to such follow-up, including travel distance/times, planning tests to coincide with other visits, and the potential stigma of hearing loss.
To combat these barriers, stakeholders suggested hiring more staff and performing more patient education. After identifying hearing loss, the instructions for follow-up were deemed essential. In addition, patients could automatically be flagged after completing treatment for referrals to hearing clinics through electronic medical records to increase participation in screening. Reminders via phone or mail for patients could be useful as well.
Disclosure: The study authors’ disclosure information may be found at coi.asco.org.