Predictors of Voice Therapy Attendance in an Interdisciplinary Care Model

Abstract

The purpose of this study is to elucidate factors associated with voice therapy attendance within the interdisciplinary care model. This was a retrospective review. Patients referred for voice therapy following interdisciplinary evaluation involving speech language pathology and laryngology were included. Independent variables were (1) duration between interdisciplinary voice evaluation and first voice therapy session, (2) plan of care determined at the time of evaluation, (3) mode of voice therapy delivery, and (4) stimulability for improvement during evaluation. Voice therapy attendance was measured as (1) attendance to the first voice therapy session and (2) overall voice therapy attendance. Of 272 patients referred for voice therapy, 69.12% attended the first session, 17.28% canceled/no-showed (C/NS), and 13.6% did not schedule the first session. Of 235 patients who scheduled voice therapy, 48.94% attended all their scheduled sessions, and 51.06% C/NS at least one session. Patients with a plan of care including voice therapy+surgery were 86% less likely (risk ratio [RR]=0.14, P=0.0014) to C/NS any of their voice therapy sessions. In contrast, patients with plan of care including voice therapy+medication were more likely to C/NS at least one voice therapy session (RR=1.27, P=0.1419), although this finding was not significant. No other covariates had a significant impact on voice therapy initiation or overall attendance. This study provides further support for the positive impact of interdisciplinary evaluation on voice therapy initiation. However, once voice therapy is initiated, overall C/NS rates are persistently high, consistent with previous investigations of voice therapy dropout. Our findings suggest that plan of care determined at the time of evaluation may have an impact on voice therapy attendance.