International Ototoxicity Management Group (IOMG)

The International Ototoxicity Management Group (IOMG) is a global consortium created to address a gap in healthcare regarding the treatment of individuals who experience hearing difficulties following the administration of ototoxic medications or exposure to ototoxicants in the environment. The group is composed by stakeholders from universities, health foundations, professional societies, and government agencies.

Ototoxicity management (OM) includes the clinical and therapeutic management of these cases. Clinical practice in these situations, particularly in the case of adult patients and infectious disease populations, is not consistent across countries.  Guided by an international team of clinicians, pharmacists, researchers, and patient stakeholders the group plans to develop and disseminate guidelines on OM in traditional and non-traditional formats with an emphasis on provider- and patient-centric educational materials. The first meeting of the group was held at the National Center for Rehabilitative Auditory Research (NCRAR) in the United States on September 28, 2019.

Objectives and Strategies edit

The long-term goal of the IOMG is to develop and implement a cohesive set of guidelines and/or position statements that will address OM care gaps and harmonize with the priorities of the medical specialties providing ototoxic therapies. To reach this goal, near-term objectives are to establish best practices for widespread implementation of OM in specific clinical environments (e.g., medical oncology, pulmonology, otology, cystic fibrosis and infectious disease clinics), health care structures (e.g., community-based, government, third party payer), and regional economies (emerging, transitional, strong). Work groups have been established to focus on the following projects:

Project 1. Conduct an environmental scan of ototoxicity management (OM) practices across myriad countries, clinical environments and patient populations to identify OM care gaps, barriers and facilitators in relation to best practice guidelines.  Established qualitative methods will be used to obtain and analyze survey and interview data in order to gain the perspectives of patient, provider and policy-maker stakeholders. Care will be taken to get input that can inform on a range of health care structures in countries with emerging, transitional and strong economies.

Project 2. Conduct literature reviews to synthesize OM guidelines, strategies and clinical practices as well as evidence on the efficacy and effectiveness of OM for improving patient- and treatment-level outcomes. In order to efficiently search for relevant literature, the PICOT framework1 will be utilized. This involves defining the patient problem, intervention, comparison, outcome and type of question to be answered and using these key structures as search criteria.

Project 3a. Develop a cohesive set of guidelines and position statements in collaboration with representatives from the specific clinical specialties and/or community health care workers providing ototoxic therapies to promote widespread OM and prevent inconsistent practices.

Project 3b. Develop patient- and provider-facing educational materials using traditional and non-traditional formats to facilitate stakeholder involvement and maintain continuity of OM care.

Projects 3a and 3b will involve determining appropriate OM schedules and methods that maximize patient outcomes while minimizing preventable ototoxicity, are tolerable for the patient and logistically feasible. This aim will be accomplished by addressing the specific populations of medically complex patients receiving ototoxic therapies, the health care structures in which the OM is administered, and by incorporating patient, provider and policy-maker input.

External Links edit