Gökce MI. et al., 2023: Patient compliance for metabolic evaluation and medical treatment (CoMET) in calcium-oxalate stone patients: prospective study by EULIS eCORE study group.

Gökce Mİ, Güven S, Petkova K, Tefik T, İbiş MA, Sönmez G, Gadzhiev N, Kiremit MC, Karagöz MA, Villa L, Sarıca K.
Department of Urology, Ankara University School of Medicine, Sancak Mahallesi Turan Güneş Bulvarı, 39/23, Çankaya, 06550, Ankara, Turkey.
Department of Urology, NEÜ Meram Medicine Faculty, Konya, Turkey.
Department of Urology and Nephrology, Military Medical Academy, Sofia, Bulgaria.
Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Department of Urology, Ankara University School of Medicine, Sancak Mahallesi Turan Güneş Bulvarı, 39/23, Çankaya, 06550, Ankara, Turkey.
Department of Urology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia.
Department of Urology, School of Medicine, Koc University, Istanbul, Turkey.
Department of Urology, Prof. Dr. Cemil Tascıoglu City Hospital Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
Department of Urology, Biruni University School of Medicine, Istanbul, Turkey.

Abstract

Purpose: In this study, we aimed to identify the compliance rates of calcium-oxalate stone patients for metabolic evaluation, diet and medical treatment and also determine the factors that are associated with poor compliance rates.

Methods: This study was conducted by the EULIS eCORE working group prospectively. In the initial visit, demographic and stone-related characteristics were recorded. Patients were suggested metabolic evaluation, dietary advices and medical treatment. Follow-up visit was performed after 3 months and compliance rates were recorded. Logistic regression analysis was performed to determine factors associated with poor compliance to metabolic evaluation, diet and medical treatment.

Results: Data of 346 patients from nine centers were analyzed. Compliance rates were 71.7%, 65.3%, and 63.7% for metabolic evaluation, diet, and medical treatment, respectively. In multivariate analysis, level of education (p = 0.003), history of emergency department visit (p = 0.04), number of stone surgeries (p = 0.03), patient care in dedicated stone clinic (p = 0.03), and history of shock wave lithotripsy (p = 0.005) were detected as independent predictors of compliance to metabolic analysis. Level of education (p < 0.001) and history of emergency department visit (p = 0.01) were detected as independent predictors of patient compliance to diet. Number of stone episodes (p = 0.03), family history of stones (p = 0.02), and polypharmacy (p < 0.001) were detected as independent predictors of patient compliance to medical treatment.

Conclusions: Patient compliance to metabolic evaluation, diet, and medical therapy is important for successful management of urolithiasis. Dietary advices and medications should be personalized by taking in to account the factors associated with poor compliance.

World J Urol. 2023 Nov;41(11):3135-3140. doi: 10.1007/s00345-023-04610-w. Epub 2023 Sep 28. PMID: 37758934