Cisplatin-associated ototoxicity: perspectives from a single institution cervical cancer cohort and implications for developing a locally responsive monitoring programme in a public healthcare setting

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dc.citation.issue1
dc.citation.volume22
dc.contributor.authorPaken J
dc.contributor.authorGovender CD
dc.contributor.authorPillay M
dc.contributor.authorSewram V
dc.coverage.spatialEngland
dc.date.accessioned2023-09-08T00:45:16Z
dc.date.accessioned2023-09-21T22:14:58Z
dc.date.available2022-06-18
dc.date.available2023-09-08T00:45:16Z
dc.date.available2023-09-21T22:14:58Z
dc.date.issued2022-06-18
dc.date.updated2023-09-06T00:37:50Z
dc.description© The Author(s) 2022.en_US
dc.description.abstractBackground Ototoxicity monitoring is uncommon in South Africa, despite the increased use of ototoxic medication to manage the burden of disease in the country. The successful implementation of such a protocol requires cognisance of contextual realities and multiple dimensions for consideration from both patients and service providers. As part of an ongoing cohort study on cisplatin-associated ototoxicity and efforts to better inform the implementation of such programmes, the perspectives of cervical cancer patients and healthcare workers towards ototoxicity monitoring were assessed. Methods This concurrent-triangulation mixed-methods study was conducted at a tertiary hospital in South Africa. Self-reported questionnaires from patients (n = 80) and healthcare personnel comprising clinicians, oncology nurses, pharmacists, and radiotherapists (n = 32), results of audiological evaluations, researcher field notes, and estimated patient and service provider costs contributed to data for this study. Data analysis included descriptive statistics, comparison of test characteristics and deductive thematic analysis. Results The ototoxicity monitoring programme was positively received by the participants, with 90.6% of healthcare personnel and 89% of patients reporting it to be beneficial. The clinicians (76.6%) were identified as the main providers of information on the effects of chemotherapy medication and made the necessary referrals for audiological evaluation. The approximate cost of setting up such a programme included purchase of equipment (US56 700) and the appointment of an audiologist (US 26 250). The approximate costs to patients included transport costs (US$ 38) and the loss of income for the day (US 60), calculated at the minimum wage per hour, if employed. Creative appointment scheduling, easy facility access and detailed locally comprehensible couselling improved patient compliance to the programme. Whilst the sequential use of American Speech-Language-Hearing Association (ASHA) and National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) criteria aided in an evidence-informed approach to aural rehabilitation, DPOAEs and speech discrimination displayed low sensitivity (range 1.45% – 22.39%) but high specificity (range 77.78% – 100%) when identifying ototoxic change. Conclusion This novel study, through a ‘real-world’ experience, has revealed that an ototoxicity monitoring programme is feasible in South Africa, through meaningful engagements with- and considerations from- patients and service providers regarding planning, delineation of responsibilities and cost implications. The findings can potentially serve as a roadmap for other limited resource environments.
dc.format.extent791-
dc.identifier10.1186/s12913-022-08099-8
dc.identifierhttps://www.ncbi.nlm.nih.gov/pubmed/35717191
dc.identifier.citationPaken J, Govender CD, Pillay M, Sewram V. (2022). Cisplatin-associated ototoxicity: perspectives from a single institution cervical cancer cohort and implications for developing a locally responsive monitoring programme in a public healthcare setting.. BMC Health Serv Res. 22. 1. (pp. 791-).
dc.identifier.doi10.1186/s12913-022-08099-8
dc.identifier.eissn1472-6963
dc.identifier.elements-typejournal-article
dc.identifier.harvestedMassey_Dark
dc.identifier.issn1472-6963
dc.identifier.urihttp://hdl.handle.net/10179/20106
dc.languageeng
dc.publisherBioMed Central Ltd
dc.relation.isPartOfBMC Health Serv Res
dc.rightsCC BY 4.0en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.subjectAudiological assessment
dc.subjectCervical cancer
dc.subjectCisplatin
dc.subjectHearing loss
dc.subjectMonitoring programme
dc.subjectOtotoxicity
dc.subjectSouth Africa
dc.subjectAntineoplastic Agents
dc.subjectCisplatin
dc.subjectCohort Studies
dc.subjectDelivery of Health Care
dc.subjectFemale
dc.subjectHearing Loss
dc.subjectHumans
dc.subjectOtotoxicity
dc.subjectUterine Cervical Neoplasms
dc.titleCisplatin-associated ototoxicity: perspectives from a single institution cervical cancer cohort and implications for developing a locally responsive monitoring programme in a public healthcare setting
dc.typeJournal article
pubs.elements-id454049
pubs.organisational-groupOther
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