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    Stone patients are poorly adherent with medical prophylaxis

    Only 50% of 22,000-patient cohort adherent to regimen, data indicate

     

    John M. Hollingsworth, MD, MSDr. HollingsworthJohn M. Hollingsworth, MD, MS, assistant professor of urology at the University of Michigan, told Urology Times, “Getting a patient to accept a prescribed regimen for kidney stone prevention and adhere to it may be difficult since a benefit of treatment is not obviously apparent to someone who is asymptomatic between stone events. Our study reinforces the need to spend time counseling patients on the importance of adherence and suggests possible targets for quality improvement in the secondary prevention of kidney stones.”

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    He noted that in addition to reinforcing the need for medication adherence through in-office education efforts, practitioners can suggest the use of a variety of aids, such as medication assistance programs or free mobile apps that remind patients to take their medications and keep track of their dosing schedule.

    In investigating the issue of adherence to medical therapy for nephrolithiasis prevention, the study focused on medications recommended by the AUA Guideline on the Medical Management of Kidney Stones to be trialed in patients with selected metabolic abnormalities. Looking at patterns of use, the data showed that 83% of patients were prescribed a monotherapy regimen with thiazide monotherapy being most common (58% of the total population).

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    In examining adherence rates for the individual medications, the study identified marked variability with adherence being best for thiazide monotherapy (42%) and lowest for alkali citrate monotherapy (~3%).

    NEXT: Reasons for low adherence

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