An Intervention to Increase 24-Hour Urine Collection Compliance
Publication date: Available online 6 February 2018
Source: Urology Practice
Author(s): Carter Boyd, Kyle Wood, Omotola Ashorobi, Lisa Harvey, Robert Oster, Ross P. Holmes, Dean G. Assimos
Compliance with 24-hour urine collections for assessing kidney stone risk is important for assigning preventive therapy. The objectives were to determine factors associated with compliance and the impact of an intervention.
Materials and Methods
In 2015, patients needing 24 hour urine testing were instructed to contact the vendor (Litholink®) and given instructions by the same nurse to arrange for collections. In 2016, a practice change was implemented and all requests were sent directly to the vendor by FAX. In 2015/2016, 24-hour urine studies were ordered in 368 adult stoneformers (SF). Demographic data included age, gender, race, insurance status, partner status, income, and education. Statistical methods included ANOVA, Fisher’s exact test, Chi-squared, and t-test. Compliance was based on completion of 24-hour urine collections. Data were analyzed for 2015, 2016, and both years combined (2015/2016).
Average age of SF was 49.6 years at time of collection; 47.5% were female; 84.2% were Caucasians;15.8% were African Americans. Most patients were adequately insured (90.5%) and had domestic partners (61.4%). Compliance increased after the intervention from 46.9% to 65.1% (p<0.001). Adequate insurance was associated with increased compliance for both years combined (58.3% vs 37.15%, p=0.017). Partner status and older age were associated with increased compliance in 2015 (54.2% vs 32.8% p=0.006; 52.9 years vs 47.1 years p=0.014), but following intervention in 2016 were no longer contributing factors.
An intervention was associated with increased compliance by 18% and eliminated health disparities (age, partner status). Inadequate insurance status resulted in poor compliance despite this intervention.