A review of patient adherence to the recommendation for voice therapy

Voice therapy is a preferred treatment for many voice problems. Many patients referred to voice therapy by their otolaryngologist fail to follow through with the recommendation. Unlike other behavior change therapies, there are no studies documenting the incidence of poor patient attendance in voice therapy. The primary purpose of this study was to document initial patient adherence to the physician's recommendation for voice therapy. A retrospective review of 294 charts was conducted at 2 voice institutions in Atlanta, GA. Reviews included adherence to (1) the physician's referral to the speech-language pathologist and (2) the speech-language pathologist's recommendation for follow-up voice therapy. Thirty-eight percent of patients did not adhere to the physician's recommendation to attend voice therapy. Of those who initiated follow-through, 47% did not return after the initial speech-language pathology evaluation session. There was no significant difference in attendance by gender or by age group. The primary reasons reported for nonattendance were insurance denials, resolution of the problem, and distance to the clinic. The attendance rates described in this study were low but consistent with research published in the fields of otolaryngology, gastroenterology, and psychology. Poor patient attendance is an important area to consider in outcomes research and the cost to healthcare.