Usage of a Mobile Health Platform for Surveillance of Kidney Stone Formers: A Prospective Study

Objectives: To develop and pilot a comprehensive mobile health (mHealth) kidney stone prevention care plan for urolithiasis patients to improve quality of life, patient satisfaction, and understanding of stone health. Methods: We conducted a randomized controlled trial comparing a mobile health care plan created with GetWell (GW) to a standard kidney stone follow-up pathway over 12 months. The app provides customized recommendations regarding dietary management, fluid intake, and medications for each patient. Check-ins included patient satisfaction, stone-related health, and Wisconsin Stone Quality of Life (WISQOL) questionnaires every 3 months. Twenty-four-hour urine studies were performed at baseline and 6 months to assess objective measures of stone recurrence risk. Results: Of the 64 randomized patients, 30 (46.9%; 23 control, 7 GW) completed 6 months of the study and are included in the analysis. Only 17 (26.6%) patients completed the entire 12-month study. There were no significant differences in WISQOL and stone satisfaction scores or 24-hour urine parameters between baseline and 6 months and between control and GW groups. The GW group had an improved total WISQOL score (−1.4 vs +3.1, P = .307), increased 24-hour urine volume (−0.08 L vs +0.35 L, P = .188), and medication adherence (54% vs 100%, P = .114), but these differences were not statistically significant. Patients in the GW group had better knowledge of fluid intake goals at 6 months (100% vs 53.8%, P = .029). Conclusions: Mobile health stone prevention plans may lead to improvement in WISQOL scores, urine volume, medication adherence, and knowledge. Further refinement of this technology is necessary given poor adherence rates.