Author(s)
Justin T. White, MA
Swapna Chandran, MD
Affiliation(s)
University of Louisville School of Medicine, Department of Otolaryngology-Head and Neck Surgery;
Abstract:
Background/Objective: Voice therapy has a poor attendance rate that adversely impacts patient outcomes and provider productivity. Studies have found that interdisciplinary evaluation, time-to-therapy, and quality-of-life measures are related to therapy attendance. This study sought to identify characteristics, including diagnosis and patient perceptions, that predict therapy attendance at an outpatient interdisciplinary voice clinic.
Methods: This retrospective chart review included patients who received a referral for voice therapy during evaluation at an interdisciplinary voice clinic. Attendance to therapy, number of therapy sessions, age, gender, primary and secondary voice-related diagnoses, quality of life measures, and measures of patient perceptions (self-rated severity, importance of voice in one’s life, and “feelings about voice therapy”) were recorded. Standard statistical analyses and logistic regressions were performed on a subset of data with no missing values and on the whole dataset with imputed values.
Results: Of 168 subjects, 111 (66.1%) attended voice therapy. A higher proportion of attenders had a primary hyperfunctional voice disorder compared to non-attenders (28.8% vs 14.0%, p=0.035). Voice Handicap Index-10 scores were correlated with self-rated severity (r=0.60, p<0.01) but were poorly correlated with attendance (r=0.22, p=0.066). Patients’ feelings about voice therapy (OR=1.691, CI:2.353-3.385), self-rated severity (OR=1.93, CI:1.32-2.82), and a diagnosis of primary hyperfunctional voice disorder (OR=3.73, CI:1.420-9.817) were predictive of attendance in the whole dataset. Patients’ feelings about voice therapy were predictive in the subset of data (OR=1.935, CI:1.021-3.664).
Conclusions: A diagnosis of primary hyperfunctional voice disorder, self-rated severity, and self-rated feelings about voice therapy were predictive of initial voice therapy attendance.