PP701 - An Evidence-Based Patient Navigator for Platinum-Based Ototoxic Monitoring

Abstract:
An evidence-based patient navigator for platinum-based ototoxic monitoring was developed based on findings from a qualitative study using human-centered design concepts and a literacy level calculator. This patient-focused resource was created in the form of a brochure and a website, available to access in patient waiting rooms and from web links and QR codes, respectively. By utilizing this educational tool, cancer patients will be appropriately informed on possible changes to their quality of life throughout and after receiving treatment and be appropriately scheduled for audiological evaluations for baseline testing and ototoxic monitoring.

Summary:
Cisplatin and carboplatin are two common platinum-based chemotherapy treatments used to treat cancers like leukemia, lymphomas, breast cancer, head and neck cancer, cervical and ovarian cancer, testicular cancer, and more. Side effects of these treatments may include high-frequency sensorineural hearing loss, tinnitus, and vestibular dysfunction. It causes irreversible dose-dependent hearing loss in 40-80% of adults and 50% of pediatric patients, leading to social isolation and depression in adults and delays in speech and language acquisition in children.

Thematic analysis of data from a focus group with 18 head and neck cancer survivors who received cisplatin-based chemotherapy revealed inconsistent referral to audiology, lack of patient education, socioeconomic factors, and hesitancy towards hearing aids. A recent study investigating compliance with ototoxicity monitoring guidelines demonstrated that less than 25% of patients treated with cisplatin had a pre-treatment audiogram.

To help improve patient access to information and understanding of ototoxicity, a patient navigator tool was created with the objective to help remove barriers to care and improve cancer survivors’ quality of life and to improve ototoxic monitoring follow-up with audiology. This patient-focused resource was created on platforms where information can be easily dispersed and referenced back throughout the course of a cancer patient's journey before, during, and after chemotherapy treatment.

This educational tool is in the form of a brochure and a website. The brochure is a trifold design, titled “Platinum-Based Chemotherapy: How It May Affect Your Hearing System & What You Need to Know About Ototoxic Monitoring” and includes a checklist and QR code for the website. The website has a copy of the brochure available to download and share in case the patients lose their original brochure. The patient tools were made in collaboration with the Health Communication Design Studio (HCDS) at Washington University’s Sam Fox School of Design & Visual Arts, who provided great insight into the patient audience’s point of view when using infographic resources and recommended using a literacy level calculator to ensure an eighth-grade reading level. For example, “hearing test” was used consistently throughout the brochure instead of “audiogram.”

Design thinking is human-centered, adopts an open-ended creative mindset towards an outcome, starts with the needs and desires of people, and involves observation, collaboration, research, and conversation. Human-centered design is a creative problem-solving approach that designers use to empathize, experiment, and evaluate to create the desired end-product that is most relevant to the targeted people’s needs. Human-centered design was incorporated into the creation of the brochure and website based on evidence-based knowledge by understanding the cancer survivor participants’ needs during the focus groups, developing the finished product through collaborations with others, and embracing feedback from others.

By utilizing and implementing this educational tool in waiting rooms and dispersing them to patients before, during, and throughout their cancer journey, even when the platinum-based chemotherapy treatment ends, cancer patients will be appropriately informed on possible changes to their quality of life throughout and after receiving treatment and be appropriately scheduled for audiological evaluations for baseline testing and ototoxic monitoring.