Garinis Angela C, Cornell Alexandra, Allada Gopal, Fennelly Kevin P, Maggiore Ronald J, Konrad-Martin Dawn
a Department of Otolaryngology - Head and Neck Surgery , Oregon Health & Science University , Portland , OR , USA.
b VA Portland Health Care System , VA RR&D Center of Excellence, National Center for Rehabilitative Auditory Research , Portland , OR , USA.
Int J Audiol. 2018 Sep;57(sup4):S19-S24. doi: 10.1080/14992027.2017.1381769. Epub 2017 Oct 5.
Integrating audiological management into the care pathways of clinical specialties that prescribe ototoxic medications for essential, often life-preserving medical care that is critical for early hearing loss identification and remediation. Research shows that successful implementation of a new health service or intervention requires alignment of goals among provider groups, institutional leadership and patients. Thoughtful consideration of the physician's viewpoints about ototoxicity and its implications for treatment planning is, therefore, important for the implementation and enduring success of an ototoxicity monitoring programme (OMP).
This discussion paper uses qualitative methods to explore the perspectives of four physicians on OMP provision in their patient populations.
Three pulmonologists and one oncologist completed the written survey or survey-based interview described in this report.
Each physician indicated that (i) ototoxicity is a potential problem for their patients; (ii) monitoring hearing is important to ensure good quality of life among their patients and (iii) treatment modification would be considered if an alternative treatment option were available. The physicians differed in their approaches to ototoxicity monitoring, from routine referrals to audiology, to relying on patient self-referral.
Physician provider input is needed to optimise monitoring schedules and OMP care coordination with audiology.
将听力学管理纳入临床专科的护理路径,这些专科会开具耳毒性药物用于必要的、往往能挽救生命的医疗护理,这对于早期听力损失的识别和补救至关重要。研究表明,成功实施一项新的健康服务或干预措施需要提供者群体、机构领导层和患者之间目标一致。因此,认真考虑医生对耳毒性及其对治疗计划影响的观点,对于耳毒性监测计划(OMP)的实施和持久成功至关重要。
本讨论文件采用定性方法,探讨四位医生对其患者群体中OMP提供情况的看法。
三位肺科医生和一位肿瘤学家完成了本报告中描述的书面调查或基于调查的访谈。
每位医生都表示:(i)耳毒性对其患者来说是一个潜在问题;(ii)监测听力对于确保患者的良好生活质量很重要;(iii)如果有替代治疗方案,会考虑调整治疗。医生们在耳毒性监测方法上存在差异,从常规转诊到听力学,再到依靠患者自我转诊。
需要医生提供者的投入,以优化监测时间表以及OMP与听力学的护理协调。