title: Audit of adult post-implant annual reviews and evaluation of patient-led review.
abstract: OBJECTIVE
  Audits were carried out to assess the clinical effectiveness of historical annual review appointments and a new patient-led review system.
  
  
  METHODS
  The written records of 100 patients who attended for an annual review appointment were retrospectively analysed. A further 50 patients who did not respond to the patient-led review offer letter were contacted to determine why they had not responded. The records of patients who subsequently attended for review were also analysed to evaluate their outcome.
  
  
  RESULTS
  Ninety-one per cent of patients tested showed no change or an improvement in aided thresholds. Eighty-nine per cent of patients tested showed no change or an improvement in speech discrimination scores. Ninety-three per cent of patients tested showed no change in impedances. Fifty-two per cent of patients required a map check and 36% of patients needed some equipment changed. One patient out of 100 needed referral to Ear, Nose and Throat (ENT). Twenty per cent of the patients who did not respond to the review offer letter reported they had not received the letter. The remainder did not require an appointment or did not understand the system.
  
  
  CONCLUSIONS
  The results indicate that the majority of patients' implant and functional performance remains stable over time. The process of patient-led review has been optimized, so patients fully understand the system and are not missed if they do not receive the letter.
  
  
  CONCLUSIONS
  Patient-led review allows patients to take more responsibility, so they can participate more proactively in the maintenance of their implant and the centre is able to focus their resources on the patients who need it.
authors.forename: Shahad
authors.initials: S
authors.lastname: Howe
authors.forename: Deborah
authors.initials: D
authors.lastname: Mawman
mesh_terms: D000158:Acoustic Impedance Tests; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D019929:Cochlear Implantation / Q000295:instrumentation / Q000534:rehabilitation*; D017050:Episode of Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013063:Speech Discrimination Tests
keywords: Cochlear implants; Post-implant annual review