A study of voice therapy dropout.

Treatment dropout is a consistent problem among behavior change therapies. A recent study by the authors demonstrated that 38% of patients did not attend a voice evaluation after referral by the otolaryngologist. Further, 47% of patients who attended a voice evaluation did not return for therapy. No previous study has set out to document completion/dropout rates for voice therapy, but high rates of attrition are reported as problematic within voice therapy research studies. The purpose of this study was to quantify the problem of voice therapy dropout over the course of voice therapy and to analyze factors that may predict dropout using a retrospective chart review. Data were collected at two voice centers and included demographics (gender, age, and race/ethnicity), quality-of-life impact (Voice Handicap Index [VHI]), severity of dysphonia (Consensus Auditory Perceptual Evaluation of Voice [CAPE-V] overall severity score), diagnosis, and completion/dropout status. Results indicated a 65% voice therapy dropout rate in this study. There was no significant difference in dropout rates for gender, age, race, VHI, CAPE-V, or diagnosis. No factor studied was strongly associated with dropout. The 65% dropout rate in this study was consistent with literature published in other behavior change fields. The variables analyzed in this study were not predictive of dropout. Future research should examine methods to effect a reduction in dropout, from otolaryngologist referral through completion of therapy.