Author(s)
Amritpal Singh, BS
Hasan Abdulbaki, BA
Lourdes Kaufman, BA
Rebecca Lewis, AuD, PhD
Nicole T Jiam, MD
Affiliation(s)
University of California, San Francisco
Abstract:
Objective: Although peak performances are achieved within one-year after cochlear implant (CI) surgery, post-implantation aural rehabilitation is not standardized among patients. Barriers to access for post-implantation appointments could have detrimental effects on patient outcomes. Thus, the study objective is to identify factors associated with missed post-implantation appointments among adult CI users.
Study Design: Retrospective cohort study.
Setting: Academic tertiary healthcare center.
Patients: Patients aged 18 or older, scheduled for the initial five post-implantation appointments within the first year of CI surgery between 2021-2023.
Results: Between 2021-2023, 97 out of the 491 implanted patients missed at least one of the follow-up appointments. 59% of these patients were 50 years of age or older, 61% were of Hispanic origin and 54% were single or divorced. 62% of the missed appointments occurred after the 1-month post-implantation appointment. Younger adult patients (ages 25-49) were more likely to make up a missed appointment (41%) compared to older adults (ages 50-75, 21%; ages >75, 28%) (p=0.04). While no gender differences were observed, Hispanics had a significantly lower appointment make-up rate (62%, p=0.048) compared to non-Hispanic patients. Multiple no shows (>1) for the same follow-up appointment was significantly higher among single or divorced patients (p = 0.05).
Conclusions: CI implant patients who are older, or of Hispanic origin and lack social support are more susceptible to missing appointments, especially after the 1-month post-implantation visit. Aural rehabilitation strategies that acknowledge and address these sociodemographic disparities may lead to improvements in post-implantation outcomes for CI users.
Professional Practice Gap & Educational Need: Follow-up care for adult cochlear implant patients is notably inconsistent among vulnerable populations. Understanding factors associated with and the broader implications of missed appointments can lead to development of targeted interventions aimed at improving post-implantation outcomes.
Learning Objective: By the end of this presentation, the audience will be able to identify factors contributing to missed follow-up appointments among adult cochlear implant patients.
Desired Result: Physicians, audiologists, and policymakers could collaborate to develop interventions aimed at addressing post-implantation non-adherence in cochlear implant users.
Level of Evidence - Level V
Indicate IRB or IACUC : Approved by the Institutional Review Board at the University of California, San Francisco (#23-39849).