Predicting No Show in Voice therapy: Avoiding the Missed Appointment Cycle

Voice therapy plays a critical role in the treatment of voice disorders. Despite positive outcomes in patients who attend voice therapy, otolaryngologists, and speech-language pathologists continue to struggle with patient compliance. Previous studies evaluating the multidisciplinary clinic model have shown better completion, VHI-10 scores, and fewer cancelation and no-shows (NS). We sought to review our own patient experience to better identify factors that predict NS rates in voice therapy.

A retrospective chart review of patients at a tertiary medical center were included if they had a scheduled appointment during a 6-month period that was cancelled or a NS. Charts were reviewed for age, gender, race, diagnosis, number of sessions attended, reason for discharge, and attending physician. NS percentage is calculated as a ratio of number cancellations to total number sessions scheduled. A multivariable general linear model was used to examine the association between NS and the listed covariates.

The study included 146 patients mean (SD) age 52.7 (16.6), where 62% were female and 72.6% were white. There is evidence that not being seen in a multidisciplinary clinic is significantly associated with NS rates in voice therapy (χ2 = 4.09, P = 0.0431). There is also evidence that non-white race is significantly associated with NS rates in voice therapy (χ2 = 11.76, P = 0.0006).

Data presented in this study further support the use of a multidisciplinary model to improve NS rates in voice therapy. The relationship between nonwhite patients and lower NS suggests another determining factor in nonadherence to voice therapy.