Increased Interval From Initial Evaluation to Initial Voice Therapy Session is Associated With Missed Voice Therapy Appointments

Gustin, Renée L.; Pielage, Kathryn C; Howell, Rebecca J.; Khosla, Siddarth; Giliberto, John Paul

doi:10.1016/j.jvoice.2019.05.007

Cited by 7 publications

(3 citation statements)

References 12 publications

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“…13,14,15 Other identified contributors to therapy nonattendance include the duration of time from referral to initial evaluation and patient perception of voice therapy as demanding or difficult. 8,9,18 Barriers to patient care are often exacerbated in minority and underinsured populations. 19 Despite this, previous studies evaluating voice therapy attendance have primarily been performed in homogenous patient populations without ethnic or language diversity.…”

Section: Introductionmentioning

confidence: 99%

Barriers to Voice Therapy Attendance in a Language‐Diverse Population

et al. 2020

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Objectives/Hypothesis: Voice therapy is an effective treatment for many voice disorders, but success depends on attendance and adherence. Many factors hinder treatment attendance, and language discordance with the provider may present an additional obstacle to attending therapy. This study evaluates factors associated with voice therapy attendance at a languagediverse, safety-net hospital.Study Design: Retrospective chart review. Methods: Retrospective review of adult patients referred to speech language pathology for treatment of voice disorders from January, 2018 to April, 2019. Primary spoken language, interpreter collaboration, and patient demographics were obtained from medical records. Multivariate analysis compared patient factors with voice therapy attendance versus nonattendance.Results: Of 422 patients, 219 (52%) attended at least one therapy session, whereas 203 (48%) did not attend (n = 120) or schedule therapy (n = 83). In multivariate analysis, only the association between public insurance and nonattendance was statistically significant (P = .016). After adjusting for interpreter use and interval between referral and first appointment, patients with private health insurance were 2.35 times more likely to attend therapy compared to those with public insurance (95% confidence interval: 1.18-4.71). Non-English language; interpreter collaboration; distance from hospital; and patient demographics, including age, gender, ethnicity, and birthplace, did not significantly correlate with attendance.Conclusions: In a culturally and language-diverse cohort of dysphonic patients, individuals with public health insurance were significantly less likely to attend voice therapy. Language-discordant therapy and interpreter collaboration was not a statistically significant barrier to therapy attendance. Additional investigation is warranted to optimize allocation of voice therapy resources for those with public health insurance and for diverse speakers of all languages.

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Section: Introductionmentioning

confidence: 99%

Barriers to Voice Therapy Attendance in a Language‐Diverse Population

et al. 2020

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“…The variability in the number of sessions in MCT could be explained by the wide variation in dysphonia severity from muscle tension dysphonia, which vary significantly from one person to another in aspects of vocal intensity, quality, pitch, resonance, flexibility, and stamina. However, according to standardization and principals of evidence‐based medicine, an effective and efficient voice therapy approach reduces treatment session time, increases the patient's motivation, and promotes patient compliance 50 …”

Section: Discussionmentioning

confidence: 99%

“…However, according to standardization and principals of evidence-based medicine, an effective and efficient voice therapy approach reduces treatment session time, increases the patient's motivation, and promotes patient compliance. 50 Second, the evaluation of acoustic measures, that are correlated to voice quality, were limited to jitter, shimmer, and harmonics-to-noise ratio. These acoustic measures have a long tradition and are still used today as objective markers of voice quality, with jitter and shimmer representing the periodicity of vocal fold vibration related to fundamental frequency and vocal intensity, respectively, and harmonics-to-noise ratio related to the degree of aperiodic noise in the acoustic voice energy.…”

Section: Caveats Limitations and Future Directionsmentioning

confidence: 99%

The Efficacy of the Manual Circumlaryngeal Therapy for Muscle Tension Dysphonia: A Systematic Review and Meta‐analysis

Latoszek

Hetjens

2023

The Laryngoscope

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ObjectiveMuscle tension dysphonia (MTD) is the most common functional voice disorder. Behavioral voice therapy is the front‐line treatment for MTD, and laryngeal manual therapy may be a part of this treatment. The objective of this study was to investigate the effect of manual circumlaryngeal therapy (MCT) on acoustic markers of voice quality (jitter, shimmer, and harmonics‐to‐noise ratio) and vocal function (fundamental frequency) through a systematic review with meta‐analysis.Data SourcesFour databases were searched from inception to December 2022, and a manual search was performed.Review MethodsThe PRISMA extension statement for reporting systematic reviews incorporating a meta‐analysis of health care interventions was applied, and a random effects model was used for the meta‐analyses.ResultsWe identified 6 eligible studies from 30 studies (without duplicates). The MCT approach was highly effective on acoustics with large effect sizes (Cohen's d > 0.8). Significant improvements were obtained in jitter in percent (mean difference of −.58; 95% CI −1.00 to 0.16), shimmer in percent (mean difference of −5.66; 95% CI −8.16 to 3.17), and harmonics‐to‐noise ratio in dB (mean difference of 4.65; 95% CI 1.90–7.41), with the latter two measurements continuing to be significantly improved by MCT when measurement variability is considered.ConclusionThe efficacy of MCT for MTD was confirmed in most clinical studies by assessing jitter, shimmer, and harmonics‐to‐noise ratio related to voice quality. The effects of MCT on the fundamental frequency changes could not be verified. Further contributions of high‐quality randomized control trials are needed to support evidence‐based practice in laryngology. Laryngoscope, 2023

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The role of patient perceptions and hyperfunctional voice disorders in predicting voice therapy attendance

White

Somasundram

2023

American Journal of Otolaryngology

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Increased Interval From Initial Evaluation to Initial Voice Therapy Session is Associated With Missed Voice Therapy Appointments

Cited by 7 publications

References 12 publications

Barriers to Voice Therapy Attendance in a Language‐Diverse Population

Barriers to Voice Therapy Attendance in a Language‐Diverse Population

The Efficacy of the Manual Circumlaryngeal Therapy for Muscle Tension Dysphonia: A Systematic Review and Meta‐analysis

The role of patient perceptions and hyperfunctional voice disorders in predicting voice therapy attendance

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