Mp26-13 What Do Patients Believe About the Effectiveness of Thiazide and Alkali Therapy for Stone Prevention?

You have accessJournal of UrologyStone Disease: Medical & Dietary Therapy (MP26)1 May 2024MP26-13 WHAT DO PATIENTS BELIEVE ABOUT THE EFFECTIVENESS OF THIAZIDE AND ALKALI THERAPY FOR STONE PREVENTION? Emily C. Serrell, Roy Jhagroo, and Kristina Penniston Emily C. SerrellEmily C. Serrell , Roy JhagrooRoy Jhagroo , and Kristina PennistonKristina Penniston View All Author Informationhttps://doi.org/10.1097/01.JU.0001009408.66023.77.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Effectiveness of medical therapy for stone prevention is compromised by suboptimal adherence. Adherence is influenced by patients' beliefs about the effectiveness of medications. If adherence to therapy is lower, relapse risk is higher, potentially affecting patients' health-related quality of life (HRQOL). Little is known about patients' beliefs in stone-prevention medications. METHODS: Patients from our stone prevention clinic who were taking thiazide diuretic (TD) and/or prescriptive alkali (PA) completed the validated 10-item Brief Medication Questionnaire (BMQ). Patients' responses about beliefs and adherence were calculated. HRQOL was assessed with the 6-item Wisconsin Stone Quality of Life short-form (WISQOL-SF). We evaluated the association between clinical parameters, type of medication, belief in effectiveness of medication, HRQOL, and stone symptoms. RESULTS: Response rate was 55% (n=171 of 310 invitations). Respondents were 58% male (vs. 50% for non-responders), 63±11 years, had a median of 3 lifetime stone events (min-max, 1 to>100), and had stone disease for median 10 years (min-max, <1 to 52). At WISQOL completion, 39% reported current stones (10% were symptomatic); 4.8% were unsure (100% were symptomatic). Overall, beliefs were more positive for PA than TD (p<0.013); patients taking TD were more likely (40%) to score below the mean for beliefs (i.e., felt less favorable) than patients taking PA (22%). No differences were observed in beliefs between gender, number of lifetime stone events, duration of stone disease, number of stone surgeries, or other factors. Self-reported adherence was lower for PA than TD (p=0.005 for difference in doses missed in the past week). However, there was no correlation between adherence and perceived effectiveness for either PA or TD and no difference in reported "bother." Among patients taking both PA and TD (n=30, 18%), those who feared long-term side effects of one medication tended to feel the same about the other (R=0.52 for correlation). Also among these patients, HRQOL correlated inversely (R≥0.36 for comparisons with both medications). In contrast, among patients taking only one of the medications, there was no correlation between concern for side effects and HRQOL. CONCLUSIONS: While patients reported no difference in "bother" between PA and TD, reported adherence to PA was lower than for TD. Nonetheless, beliefs about the effectiveness of PA were stronger and correlated more strongly with HRQOL and was not dependent on number of lifetime stone events or duration of stone disease. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e418 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Emily C. Serrell More articles by this author Roy Jhagroo More articles by this author Kristina Penniston More articles by this author Expand All Advertisement PDF downloadLoading ...