Improving ototoxicity monitoring in patients receiving aminoglycosides using a novel digital approach: a quality improvement project Article Swipe
Jamie Cheong
,
Shereen Boreland
,
Elaine Shattock
,
E. Bowman
,
Barbara Belkarty
,
Andrew Jones
,
I. Felton
,
E Ukor
,
Janet Stowell
,
Ricardo J. José
,
Su Madge
,
Julie Wilkins
,
Emily Frost
,
Presanna Premachandra
,
Michael R. Loebinger
,
Nicholas J. Simmonds
,
Francis Drobniewski
,
Anand Shah
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1136/bmjoq-2024-002847
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1136/bmjoq-2024-002847
Aminoglycoside antibiotics cause ototoxicity for which baseline audiometric testing is recommended but often not done. Barriers to successful implementation include limited availability of sound-booths and audiologists. An ototoxicity monitoring programme (OMP) was implemented using tablet-based audiometry (TBA) by non-audiologists. A quality improvement project conducted over 1 year (19 April 2021 to 18 April 2022), using Plan Do Study Act (PDSA) cycles, monitored the adherence to the OMP using Shoebox Standard Edition application on iPads. Barriers to adoption were identified to determine potential solutions for improved adherence. Adult respiratory patients (cystic fibrosis (CF), bronchiectasis, non-tuberculosis mycobacteria (NTM) infection) aged 17–82 years receiving >1 day of intravenous aminoglycosides (IVAGs) at a single tertiary-referral hospital were included. Other reported outcomes were patient characteristics, risk factors associated with abnormal hearing and ototoxic shift. 73 patients were tested in the OMP (46 received ≥2 hearing tests) giving an overall adherence rate of 69% after 12 months. Patient identification using referral and reporting systems initially improved adherence from 36% to 88% (p=0.03) during PDSA 1. Barriers to successful adherence were staff availability and COVID-19 infection outbreaks (p=0.057). Older age (p<0.001), higher Body Mass Index (p=0.041), non-CF bronchiectasis (p=0.01), non-CF NTM (p=0.028) and higher Hearing Handicap Inventory for Adults scores (p=0.002) were significantly associated with abnormal baseline hearing. 78% with hearing loss were asymptomatic. Ototoxic shift was associated with gentamicin use compared to amikacin/tobramycin (p=0.027). TBA was associated with high usability in patients ≤50 years old. TBA by non-audiologists was feasible and demonstrated good patient usability, permitting screening of patients within 72 hours of starting IVAG and earlier referrals for formal audiometry. Hearing loss and ototoxicity were detected at earlier stages, enabling more rapid decision-making and treatment modification.
Related Topics
Concepts
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1136/bmjoq-2024-002847
- OA Status
- gold
- References
- 40
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4409451098
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4409451098Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1136/bmjoq-2024-002847Digital Object Identifier
- Title
-
Improving ototoxicity monitoring in patients receiving aminoglycosides using a novel digital approach: a quality improvement projectWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2025Year of publication
- Publication date
-
2025-04-01Full publication date if available
- Authors
-
Jamie Cheong, Shereen Boreland, Elaine Shattock, E. Bowman, Barbara Belkarty, Andrew Jones, I. Felton, E Ukor, Janet Stowell, Ricardo J. José, Su Madge, Julie Wilkins, Emily Frost, Presanna Premachandra, Michael R. Loebinger, Nicholas J. Simmonds, Francis Drobniewski, Anand ShahList of authors in order
- Landing page
-
https://doi.org/10.1136/bmjoq-2024-002847Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://doi.org/10.1136/bmjoq-2024-002847Direct OA link when available
- Concepts
-
Ototoxicity, Medicine, Bronchiectasis, Amikacin, Referral, Gentamicin, Audiometry, Hearing loss, Internal medicine, Emergency medicine, Pediatrics, Antibiotics, Audiology, Chemotherapy, Lung, Family medicine, Biology, Cisplatin, MicrobiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
0Total citation count in OpenAlex
- References (count)
-
40Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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