Are patients with a hearing impairment or other language barriers getting equitable access to deep inspiration breath hold (DIBH) techniques for breast cancer radiotherapy?

Abstract Introduction: Few breast cancer radiotherapy studies include either patients with a hearing impairment or non-English speakers. Literature about healthcare and cancer care in general provided insights into reports by patients of disparities. Given technological advancements, it is reasonable to believe communication barriers should be surmountable, prompting a survey of radiotherapy departments to assess the status quo. Methods: A survey was conducted of all UK National Health Service (NHS) radiotherapy departments in England. A questionnaire was designed to determine if a deep inspiration breath hold (DIBH) technique was used for breast cancer radiotherapy, the equipment that was used and whether patients with a hearing impairment or other language barriers received the same treatment. Results: A total of 22 radiotherapy departments responded to the survey. All respondents reported using DIBH as a heart-sparing technique; 100% ( n = 22) reported offering DIBH to non-English speakers and 73% ( n = 16) DIBH to patients with a hearing impairment. 45% ( n = 10) stated that they use verbal instruction only, and 23% ( n = 5) a combination of both verbal and visual aids and references. Conclusion: The study highlights some novel efforts in radiotherapy departments to increase equitable access to DIBH; however, the results indicate that verbal communication methods still dominate practice, and these are not inclusive of all hearing-impaired patients. Such methods would also require translation for non-English speakers. The study suggests that more work needs to be done before equitable access is achieved for patients with a hearing impairment or other language barrier.