Attrition Across the Adult Cochlear Implant Care Pathway: A Scoping Review of Stage-Specific Disengagement

OBJECTIVES: To synthesize evidence on attrition across the adult cochlear implant care pathway by identifying (1) stages at which adults disengage or experience delay and (2) patient-, provider-, and system-level factors associated with attrition at each stage. DATA SOURCES: PubMed/MEDLINE, Scopus, CINAHL, and the Cochrane Library.

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Clinics should audit their cochlear implant care pathways for stage-specific dropout points, as this review identifies actionable patient- and provider-level barriers that could be addressed to improve access and completion rates.

Reducing attrition across the cochlear implant care pathway is critical to ensuring that eligible adults with severe hearing loss actually receive life-changing treatment, addressing a well-documented gap between candidacy and implantation.

1. 01Scoping review identifies where and why adult patients disengage from the cochlear implant care pathway.
2. 02Both patient-level factors (e.g., cost, awareness, motivation) and provider-level factors (e.g., referral delays, wait times) drive attrition.
3. 03Dropout occurs at multiple distinct stages: referral, evaluation, candidacy determination, surgical scheduling, and follow-up.
4. 04Findings have direct implications for improving access and reducing inequities in cochlear implant uptake.
5. 05Published in Otology & Neurotology as a scoping review synthesizing existing evidence.

PMID

42679062

DOI

10.1097/MAO.0000000000005050.

Journal

Otology & Neurotology

Publication type

scoping_review

Evidence level

na

Population

Adults undergoing or eligible for cochlear implantation

Intervention

Scoping review of attrition factors across cochlear implant care pathway stages