Ototoxicity management: An investigation into doctors' knowledge and practices, and the roles of audiologists in a tertiary hospital.
BACKGROUND
A significant number of medications that are prescribed by doctors to treat cancers, tuberculosis and infections are ototoxic. Disclosure of ototoxic risks is ethical practice as patients have the right to be properly informed about and involved in decisions about their health care. Often, doctors fail to disclose such information.


OBJECTIVE
This research investigated whether a group of doctors working in a South African academic hospital inform their patients about the ototoxic risks associated with specific medications, and if not, explore the reasons for it. It was determined what the participants' knowledge levels of ototoxicity were as knowledge is seen as a precursor to disclosing information to their patients. A further aim of the research was to determine whether audiologists should expand their role by sharing information with patients and other professionals in the management of ototoxicity and in the hospital.


METHODS
There were 90 participants included in the study through convenience sampling, which represented interns, medical officers, registrars and consultants in the neonatal intensive care unit, intensive care unit, ear-nose-throat, and internal and family medicine departments. The research made use of a descriptive survey design that collected mainly quantitative data and a limited amount of qualitative data through questionnaires. The data were descriptively analysed, and the qualitative data were listed and quantified.


RESULTS
The research firstly determined the participants' knowledge and understanding of ototoxicity, and it was found that there was room for improvement. With reference to the current practices of doctors in the prescription of ototoxic medicines, it was found that disclosure of ototoxic risks was limited, mostly because of a lack of time and insufficient knowledge. In comparing knowledge and practices between levels of employment, it was found that particular post levels performed better than others. The participants regarded the role of the audiologist as team member important, although very few referred their patients for audiological monitoring when they prescribe ototoxic medication.


CONCLUSIONS
A need for additional support to doctors was identified, which indicates that audiologists should expand their role to include the provision of continued professional development activities and to renew their efforts to advocate their role in the hospital so that doctors are made aware of the importance to refer their patients for ototoxic screening and monitoring.
Centre for Medical Ethics and Law, University of Stellenbosch. anna-marie.wium@smu.ac.za.
Anna
A
Wium
Berna
B
Gerber
D000328:Adult; D000890:Anti-Infective Agents / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000009:adverse effects*; D000072018:Audiologists; D007758:Ear, Inner / Q000187:drug effects; D005069:Evaluation Studies as Topic; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007231:Infant, Newborn; D033183:Interdisciplinary Communication; D000070516:Intersectoral Collaboration; D010353:Patient Education as Topic; D010819:Physician's Role; D013019:South Africa; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
D000890:Anti-Infective Agents; D000970:Antineoplastic Agents; D000995:Antitubercular Agents