Purpose: The study was designed to determine whether demographic or treatment variables affected audiologic rehabilitation service utilization during and following exposure to cisplatin chemotherapy.
Background: Hearing loss from cisplatin chemotherapy can adversely impact a veteran’s quality of life (QOL), psychosocial functioning, and ability to obtain and understand basic health information. Efforts to monitor hearing and support successful communication are crucial; however, current hearing monitoring protocols are inconsistent across VA hospitals and may not be utilized to their potential for various reasons.
Methods: This was a retrospective medical record review of more than 100 veterans identified from the cancer registry as receiving cisplatin at the Portland VAMC between May 1, 2013, and December 31, 2014. The individual chart review study period, when available, was for 1 year following the end of treatment for cancer. Data extracted from the electronic medical records included patient demographics, cancer-related characteristics, audiology service utilization, and cancer treatment information.
Data Analysis: Study outcomes were the use of audiologic services, defined as receiving ototoxicity monitoring (yes/ no) and rehabilitation for hearing loss (yes/no). Descriptive statistics were calculated for subject demographics and chemotherapy treatment characteristics. Categorical data were analyzed using the chi-square distribution, and continuous data were analyzed using the independent sample t test and nonparametric correlates employed as necessary. Univariate associations were then considered in a multivariate logistic regression model to determine the influence of demographic and treatment variables on audiologic service uptake.
Results: The findings revealed inconsistent use of audiologic services for ototoxic monitoring and aural rehabilitation. The few veterans who received adequate audiologic services were explored qualitatively. In addition, the apparent barriers to the provision of services were highlighted, including too few consults from oncology for ototoxicity monitoring and difficulty in scheduling in the audiology clinic.
Conclusions: With improved survivability following cancer treatment, veterans treated with cisplatin should have full access to audiologic rehabilitative services in order to mitigate the negative effects of hearing loss on QOL. The results suggest that many veterans need support to access audiology services and that ototoxic monitoring programs should address the barriers to utilization of these services.