OBJECTIVES: To obtain information on compliance to therapy and study its effect on recurrences. Over the past 20 years, a selective therapy protocol has been formed for prevention of urolithiasis recurrence. Many studies have been performed on the effectiveness of this therapy, but compliance has never been examined. METHODS: Data were abstracted from 177 medical records of patients who were seen at the outpatient clinic between 1985 and 1994. At that time, they were advised to follow a specific therapy regimen (high fluid intake, medication, and/or specific diet) on the basis of the outcome of a standardized metabolic evaluation. RESULTS: Thirty-six percent of the study population was still compliant to the prescribed therapy after a mean period of 5.3 years of follow-up. Therapy-compliant patients were older and had had more treatments, more lithiasis-related complaints, and more frequent follow-up visits. These characteristics suggest that patients' awareness of their disease might improve compliance. Survival analyses showed that patients can be classified into two groups characterized by the frequency of stone formation: a single stone episode versus frequent periods of stone formation. It appeared that the stone recurrence rate was twice as high among patients with a history of frequent stones compared with patients with a single stone episode, even though compliance to therapy seemed lower in the latter group. CONCLUSIONS: The usefulness of urometabolic evaluation and subsequent therapy advice seems questionable. Compliance to a life-long therapy is very low after a relatively short follow-up period. This study also suggests a prognostic classification based on stone rate.
OBJECTIVES: To obtain information on compliance to therapy and study its effect on recurrences. Over the past 20 years, a selective therapy protocol has been formed for prevention of urolithiasis recurrence. Many studies have been performed on the effectiveness of this therapy, but compliance has never been examined. METHODS: Data were abstracted from 177 medical records of patients who were seen at the outpatient clinic between 1985 and 1994. At that time, they were advised to follow a specific therapy regimen (high fluid intake, medication, and/or specific diet) on the basis of the outcome of a standardized metabolic evaluation. RESULTS: Thirty-six percent of the study population was still compliant to the prescribed therapy after a mean period of 5.3 years of follow-up. Therapy-compliant patients were older and had had more treatments, more lithiasis-related complaints, and more frequent follow-up visits. These characteristics suggest that patients' awareness of their disease might improve compliance. Survival analyses showed that patients can be classified into two groups characterized by the frequency of stone formation: a single stone episode versus frequent periods of stone formation. It appeared that the stone recurrence rate was twice as high among patients with a history of frequent stones compared with patients with a single stone episode, even though compliance to therapy seemed lower in the latter group. CONCLUSIONS: The usefulness of urometabolic evaluation and subsequent therapy advice seems questionable. Compliance to a life-long therapy is very low after a relatively short follow-up period. This study also suggests a prognostic classification based on stone rate.
Authors: David E Conroy; Ashley B West; Deborah Brunke-Reese; Edison Thomaz; Necole M Streeper Journal: Health Psychol Date: 2020-12 Impact factor: 4.267
Authors: Kimberly Tay; Anojan Navaratnam; Sean McAdams; Mira Keddis; Matthew Neville; Mitchell R Humphreys Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2019-05-27
Authors: Gaurav Gupta; Mukha R Paul; Santosh Kumar; Antony Devasia; N V Mahendri; Prasanna Samuel; Nitin S Kekre; Ninan K Chacko Journal: Indian J Urol Date: 2012-10