Barriers to successful completion of voice therapy

ABSTRACT Numerous studies have demonstrated the efficacy of voice therapy in improving outcomes for voice disorders. Additionally, it has been shown that there are significant barriers to accessing and attending voice therapy, especially in language-diverse populations and among those with public insurance. However, there is limited research identifying obstacles to completion of voice therapy among a socioeconomically diverse population. In the present study, we aim to assess the barriers to successful completion of voice therapy. We conducted a retrospective chart review of patients in the Bronx, New York. We aimed to identify demographic characteristics (age, race, and insurance status), number of canceled/missed appointments, successful completion of voice therapy, and noted barriers to completion of treatment as patients underwent voice therapy. We conducted a chart review with a sample size of 54 patients. The mean age was 54 years (age distribution 7–86 years), and 76% of the patients were female. The most common primary diagnosis was dysphonia (90%). The most common comorbidities among patients were gastroesophageal reflux disease (41%), allergic rhinitis (41%), hypertension (40%), and asthma (20%). Among the sample, 22% of the patients indicated their primary language as Spanish. Most of the patients identified (65%) were utilizing public health insurance (Medicare/Medicaid). The average percentage of missed appointments to total appointments was 30%. The therapy completion rate among the sample was 60%. There was a significant positive relationship between therapy completion and self-reported voice improvement. Overall, the most common barriers to therapy completion were nonadherence to home exercises and telehealth issues. Other common barriers include additional health issues, work commitments, family commitments, and fatigue/pain with exercises. There were also patients who identified that they did not encounter barriers to voice therapy completion (28%). We aim to utilize these results to guide further research and address issues associated with successful voice therapy completion.