title: Attendance in voice therapy: can an interdisciplinary care model have an impact?
abstract: OBJECTIVE
  We sought to determine the effect of referral patterns on attendance in voice therapy.
  
  
  METHODS
  Patients who were seen by a laryngologist for vocal concerns and referred for voice therapy comprised the study population. Outcomes were compared between those who were initially evaluated through the interdisciplinary voice clinic (IDC), which combined speech-language pathology and laryngology care, and those who were evaluated by a laryngologist alone. Adherence was measured by completion of the plan of care.
  
  
  RESULTS
  There were 79 patients evaluated through the IDC and 100 patients evaluated initially by a laryngologist. Patients evaluated through the IDC had more visits with the speech-language pathologist (mean, 3.1 versus 1.24; p < 0.0001). Those initially evaluated through the IDC were more likely to complete their plan of care (p = 0.02). Completion of voice therapy was significantly more likely for individuals coded as being of "other" race (odds ratio, 7.98; p = 0.002) and for patients who participated in the IDC (odds ratio, 2.56; p = 0.018). The cause of dysphonia, sex, marital status, insurance status, days from laryngology referral to the initial speech-language pathologist consultation, the initial Voice-Related Quality of Life score, and distance to the clinic were not associated with patient attendance.
  
  
  CONCLUSIONS
  Patients evaluated in a coordinated IDC should be more likely to attend voice therapy and complete their plan of care, regardless of other factors.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Starmer
authors.forename: Zaneta
authors.initials: Z
authors.lastname: Liu
authors.forename: Lee M
authors.initials: LM
authors.lastname: Akst
authors.forename: Christine
authors.initials: C
authors.lastname: Gourin
mesh_terms: D000328:Adult; D000368:Aged; D055154:Dysphonia / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013066:Speech-Language Pathology / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014834:Voice Training; D055815:Young Adult
keywords: dysphonia; interdisciplinary care; patient adherence; patient compliance; therapy attendance; voice therapy