{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:46:09Z","timestamp":1792053969629,"version":"4.4.0"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and Objectives<\/jats:title>\n                    <jats:p>Effective patient adherence to physician\u2010recommended care plans is critical for optimal health outcomes. Poor adherence can delay diagnosis, prolong symptoms, and worsen disease progression. Limited data exist on rates of patient adherence in laryngology and the barriers contributing to these gaps. This study aimed to quantify task completion rates following laryngology visits and identify factors associated with incomplete task completion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>A mixed methods quality improvement initiative was conducted on consecutive adult patients evaluated at the UCSF Voice and Swallowing Center. Retrospective review identified physician recommended care plans, including follow\u2010up visits; voice, swallowing, or upper airway (collectively, speech) therapy; specialty referrals; imaging; and prescriptions. Structured prospective phone interviews were conducted for incomplete tasks and categorized as patient\u2010level barriers, system\u2010level failures, or process gaps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 335 patients with an actionable item were included (mean age 60.5\u2009years, 55% female), yielding 625 total tasks. Overall, 133 tasks (19.9%) were not completed, corresponding to 91 patients (27.2%). Incomplete task completion rates varied by task type: follow\u2010up (17.5%), speech therapy (25.2%), specialty referrals (32.6%), imaging (12.2%), and medications (13.4%). Among incomplete tasks with identified causes, 73.5% involved patient\u2010level barriers and 26.5% represented system\u2010level factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Approximately one in five physician recommendations following laryngology visits are not completed. Both patient\u2010 and system\u2010level factors contribute to poor adherence. Targeted interventions addressing communication, referral workflows, and care coordination may improve adherence and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70740","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T02:29:46Z","timestamp":1786674586000},"page":"4903-4907","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploration of Patient Adherence to Physician Recommendations in Laryngology Clinics"],"prefix":"10.1002","volume":"136","author":[{"given":"Jennifer A.","family":"Silver","sequence":"first","affiliation":[{"name":"UCSF Voice &amp; Swallowing Center, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riley","family":"Jackson","sequence":"additional","affiliation":[{"name":"UCSF Voice &amp; Swallowing Center, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3840-1243","authenticated-orcid":false,"given":"Zachary","family":"Brumm","sequence":"additional","affiliation":[{"name":"University of California School of Medicine  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meera","family":"Kohli","sequence":"additional","affiliation":[{"name":"UCSF Voice &amp; Swallowing Center, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7070-1342","authenticated-orcid":false,"given":"Tyler W.","family":"Crosby","sequence":"additional","affiliation":[{"name":"UCSF Voice &amp; Swallowing Center, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah L.","family":"Schneider","sequence":"additional","affiliation":[{"name":"UCSF Voice &amp; Swallowing Center, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1571-1086","authenticated-orcid":false,"given":"Clark A.","family":"Rosen","sequence":"additional","affiliation":[{"name":"UCSF Voice &amp; Swallowing Center, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3095-8290","authenticated-orcid":false,"given":"VyVy N.","family":"Young","sequence":"additional","affiliation":[{"name":"UCSF Voice &amp; Swallowing Center, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1758-3276","authenticated-orcid":false,"given":"Yue","family":"Ma","sequence":"additional","affiliation":[{"name":"UCSF Voice &amp; Swallowing Center, Department of Otolaryngology\u2010Head and Neck Surgery University of California San Francisco  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-200209000-00009"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.22.2880"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.22.2868"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4065\/mcp.2010.0575"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e31819a5acc"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.23.2.207"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-05912-0"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-11921-0"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.2196\/50242"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26816"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2006.09.009"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2007.10.009"},{"key":"e_1_2_8_14_1","unstructured":"W. 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