TY - JOUR
T1 - Audiologists’ perceived value of ototoxicity management and barriers to implementation for at-risk cancer patients in VA
T2 - the OtoMIC survey
AU - Konrad-Martin, Dawn
AU - Polaski, Rachel
AU - DeBacker, J. Riley
AU - Theodoroff, Sarah M.
AU - Garinis, Angela
AU - Lacey, Cecilia
AU - Johansson, Kirsten
AU - Mannino, Rosemarie
AU - Milnes, Trisha
AU - Hungerford, Michelle
AU - Clark, Khaya D.
N1 - Funding Information:
This material is the result of work supported with resources and the use of facilities at the VA Rehabilitation Research and Development (RR&D) National Center for Rehabilitative Auditory Research (NCRAR) [Center Award #C2361C/I50 RX002361] at the VA Portland Health Care System in Portland, Oregon and through funding from a VA RR&D Merit Review Award to Dawn Konrad-Martin [#C3127R/I01 RX003127].
Funding Information:
The authors thank Jayden Sarabia for assistance reviewing literature and compiling tables; and the Department of Defense Hearing Center of Excellence, Pharmaceutical Interventions for Hearing Loss, Ototoxicity Committee for allowing us to use some questions from their unpublished survey. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the US Veterans Health Administration or the United States Government. Authors DK-M, RD, ST, AG, TM and KC are members of the International Ototoxicity Management Group (IOMG). This manuscript is intended to align with the IOMG mission and views regarding effective ototoxicity management (https://www.ncrar.research.va.gov/ClinicianResources/IOMG.asp#:~:text=National%20Center%20for%20Rehabilitative%20Auditory%20Research,%28NCRAR%29%20International%20Ototoxicity%20Management%20Group%20%28IOMG%29).
Publisher Copyright:
© 2023, This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.
PY - 2023/2
Y1 - 2023/2
N2 - Purpose: Platinum-based chemotherapies used to treat many types of cancers are ototoxic. Ototoxicity management (OtoM) to mitigate the ototoxic outcomes of cancer survivors is recommended practice yet it is not a standard part of oncologic care. Although more than 10,000 patients each year are treated with platinum-based chemotherapies at the US Veterans Health Administration (VA), the current state of OtoM in VA is not well-defined. This study reports on a national survey of VA audiologists’ perceptions regarding OtoM in cancer patients. Methods: A 26-item online survey was administered to VA audiologists and service chiefs across the VA’s 18 regional systems of care. Descriptive statistics and deductive thematic analysis were used to analyze the data. Results: The 61 respondents included at least one from each VA region. All reported they felt some form of OtoM was necessary for at-risk cancer patients. A pre-treatment baseline, the ability to detect ototoxicity early, and management of ototoxic effects both during and after treatment were considered high value objectives of OtoM by respondents. Roughly half reported routinely providing these services for patients receiving cisplatin and carboplatin. Respondents disagreed regarding appropriate hearing testing schedules and how to co-manage OtoM responsibilities with oncology. They identified barriers to care that conformed to three themes: care and referral coordination with oncology, audiology workload, and lack of protocols. Conclusions: Although VA audiologists value providing OtoM for cancer patients, only about half perform OtoM for highly ototoxic treatment regimens. The OtoMIC survey provides clinician perspectives to benchmark and address OtoM care gaps. Implications for cancer survivors: Collaboration between oncology and audiology is needed to improve current OtoM processes, so that cancer survivors can have more control over their long term hearing health.
AB - Purpose: Platinum-based chemotherapies used to treat many types of cancers are ototoxic. Ototoxicity management (OtoM) to mitigate the ototoxic outcomes of cancer survivors is recommended practice yet it is not a standard part of oncologic care. Although more than 10,000 patients each year are treated with platinum-based chemotherapies at the US Veterans Health Administration (VA), the current state of OtoM in VA is not well-defined. This study reports on a national survey of VA audiologists’ perceptions regarding OtoM in cancer patients. Methods: A 26-item online survey was administered to VA audiologists and service chiefs across the VA’s 18 regional systems of care. Descriptive statistics and deductive thematic analysis were used to analyze the data. Results: The 61 respondents included at least one from each VA region. All reported they felt some form of OtoM was necessary for at-risk cancer patients. A pre-treatment baseline, the ability to detect ototoxicity early, and management of ototoxic effects both during and after treatment were considered high value objectives of OtoM by respondents. Roughly half reported routinely providing these services for patients receiving cisplatin and carboplatin. Respondents disagreed regarding appropriate hearing testing schedules and how to co-manage OtoM responsibilities with oncology. They identified barriers to care that conformed to three themes: care and referral coordination with oncology, audiology workload, and lack of protocols. Conclusions: Although VA audiologists value providing OtoM for cancer patients, only about half perform OtoM for highly ototoxic treatment regimens. The OtoMIC survey provides clinician perspectives to benchmark and address OtoM care gaps. Implications for cancer survivors: Collaboration between oncology and audiology is needed to improve current OtoM processes, so that cancer survivors can have more control over their long term hearing health.
KW - Drug monitoring
KW - Drug-related side effects and adverse reactions
KW - Hearing loss
KW - Ototoxicity
KW - Professional practice gaps
KW - Survey
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U2 - 10.1007/s11764-022-01316-7
DO - 10.1007/s11764-022-01316-7
M3 - Article
AN - SCOPUS:85146163257
SN - 1932-2259
VL - 17
SP - 69
EP - 81
JO - Journal of Cancer Survivorship
JF - Journal of Cancer Survivorship
IS - 1
ER -