Advocacy and Research Holly Teagle, AuD CIG 21 November 2020 Northern Cochlear Implant Programme
NCIP
Expanding markets around the world
Over 750,000 cochlear implant users worldwide
Technology is efficient, effective, reliable, ever-improving Abundant research findings on impact of CI, beyond hearing, speech & language‌executive function, improved theory of mind
Our first generation of CI children have grown up and realized academic and vocational goals commensurate with hearing peers
Mounting evidence of the role of hearing in reducing effects of ageing, dementia and improving the quality of life
Global burden of hearing loss • Hearing loss is one of the leading causes of overall disability worldwide • Globally, approximately 466 million adults and children (6%) have a disabling hearing loss
900
• This is projected to rise to 630 million by 2030 and to over 900 million by 2050
• Hearing loss has a substantial impact on people’s lives (e.g. communication difficulties and reduced well-being1)
Millions of people living with hearing loss globally
630 466
2018
2030
2050
1. World Health Organization. Addressing the rising prevalence of hearing loss. 2018. Available from: http://apps.who.int/iris/bitstream/10665/260336/1/9789241550260-eng.pdf (Accessed June 2019)
What do we know? Benefits have been demonstrated but adoption is low
Prevalence of severe to profound hearing loss2 Adoption in those eligible* for CIs3,4,5
Global adult hearing loss (2018)
Delphi consensus process and achieving standard of care Report of clinical evidence and expert opinion on cochlear implantation in adults Findings from the Delphi process have the potential to: o help establish CIs as the standard of care for adults with severe to profound SNHL o raise awareness of CI as a treatment option and when it should be considered o achieve appropriate improved access to CIs for patients who would benefit o help optimize patient pathways, leading to treatment that improves the individual’s hearing function and quality of life 5
CI, cochlear implant; SNHL, sensorineural hearing loss
JAMA Otolaryngology Head Neck Surg. 2020;146(10): 942-952
Review of immunisation records of 135 Cochlear implant recipients over the last 5 years New Zealand Medical Journal 13 March 2020 Vol 133 No 1511
Results
• 62.2% had influenza vaccination
• 29% had received the PCV 13 vaccine • 40% had received the 23 PPV • 14.8% received a full pneumococcal immunisation schedule • 11.9% had received HiB immunisations
Summary The vaccination rate of CI patients implanted by the Northern Cochlear Implant Programme in New Zealand is low There have been no cases of meningitis post CI in this population Full funding for vaccination for cochlear implant recipients was included in the 2017 revision of guidelines by the Immunisation Advisory Centre http://www.immune.org.nz/hot-topic/fundedvaccines-special-groups-1st-july-2017
Increased awareness about vaccination for cochlear implant recipients in New Zealand is needed
Quality of Life and Depression Indices before and after Cochlear Implantation in Adults Ellen Giles, Caroline Selvaratnam, Derek Hadfield & Holly Teagle The Northern Cochlear Implant Programme (adults)
Who have we helped? • The Hearing House supports 509 adults with cochlear implants age 19 to 95 years old • approx. 10 referrals per month- a record 24 adults referred Dec 2019 • 41 on waiting list
(#s at end Jan 2020)
Age range of adults implanted July 2018- Feb 2020 (reported in this study)
Under 65
39
65 to 75
22
75 to 85
11
85 plus
4 Total 76
Quality of Life/Social Participation QoL 5
5 Higher QoL
Post-implant
4
3
2
1
0 Lower QoL 0 0
1
2
3
Pre-implant
4
5
Nicole Zhao MAud Master’s Thesis Electroacoustic Hearing: An exploratory study into the candidacy and benefits of electroacoustic devices in New Zealand
Electro-Acoustic Stimulation (EAS)
Part 1: Questionnaire of NZAS Audiologists knowledge of EAS and current fitting practices of individuals with steeply sloping HL Part 2: Review THH recipients who could be a candidate for EAS Records for 382 individuals aged 19 and above with a N6 or N7 processor Only 12 were identified as fulfilling pre-operative audiometric criteria of thresholds <70dB HL at 250-750Hz. One adolescent recruited- Case Study
Summary and Conclusions • Limitations in knowledge of EAS candidacy has been demonstrated in New Zealand audiologists. • While audiologists are aware of what EAS is, they may not refer candidates until residual hearing is too poor to take advantage of the technology. This is likely a reflection of restricted
funding and stringent criteria for CI consideration in adults, resulting in limited exposure and awareness of EAS. • For this recipient, use of EAS compared to the electric only program yielded improvements in speech perception outcomes in noise • Greater awareness of CI candidacy to include the population who could benefit from EAS could result in more referrals and potentially better client outcomes with hearing technologies in general.
Support Research at THH and NCIP Research helps us understand the impact of hearing loss and how to best use technologies and/or practices to overcome its consequences.
Research may sometimes be perceived as being time consuming and invasive. Indeed, it can require extra time and effort but it also offers everyone an opportunity to contribute to the expanding pool of knowledge. Participation is voluntary and â&#x20AC;&#x153;giving backâ&#x20AC;? is always appreciated. The Hearing House has a special alliance with the University of Auckland and the centres for research within its domain. In addition to sharing personnel resources, there is a mutual focus on collaboration for research. As these projects progress, we will be inviting The Hearing House family to participate as able and as interested.
Habilitationists Audiologists Holly Teagle Caroline Selvaratnam Ellen Giles Derek Hadfield Rene Orams Dianne Rafter Denice Bos Robyn Moriarty Laura Le Roux
Northern Cochlear Implant Programme
NCIP
Aaron Henley Victoria Holgate Aishwarya Suresh Kumar Amy Waite
Northern Cochlear Implant Programme Surgeons Michel Neeff Collin Brown Bill Baber Melanie Collins David Flint
Kia Ora! Administration & Staff Support Claire Green Jacqui Grout Rosemary Such Akshaya Arun Gillian Doyle Dawn Thompson Silvia Rosioru Megan Levi Nicki Shaw Donna Quinn Jess Thornton