Presentation Authors: Anirban P Mitra*, Jamal Nabhani, Los Angeles, CA, Manoj Monga, Cleveland, OH, Mike Nguyen, Los Angeles, CA
Introduction: Overall adoption of strategies to reduce urolithiasis recurrence by pts remains low. We evaluated attitudes of urolithiasis pts towards adopting lifestyle and therapeutic interventions, with emphasis on differences among racial groups.
Methods: 253 pts were surveyed for their willingness, confidence, and degree of perceived benefit necessary to adopt dietary changes (increase fluid intake, sodium and meat reduction, avoid specific foods), taking over-the-counter supplements, and a daily medication to prevent stone recurrence.
Results: Mean age was 51 years. 49% were female; 76% Caucasian (C), 12% Hispanic (H), and 12% other races (O). Respondents were most willing to increase fluid intake (91% fully willing), decrease salt (67%), and use supplements (56%). They were less willing to decrease meat (50%), take medications (47%), and avoid certain foods (46%). Respondents were most confident in their ability to sustain high fluid intake (62% extremely confident); this also corresponded with the lowest degree of benefit necessary to adopt this intervention (38% willing to increase fluids for any reduction in stones). H were more likely to be unwilling to take any daily medication (C 12%, H 38%, O 25%; p=0.005). Correspondingly, a higher percentage of H were only willing to adopt an intervention if the perceived benefit was an absolute prevention in stone recurrence. This was noted for fluid intake (C 29%, H 68%, O 30%; p=0.001), salt intake (C 24%, H 63%, O 25%; p=0.005), meat intake (C 27%, H 67%, O 18%; p=0.001), avoiding certain foods (C 28%, H 62%, O 25%; p=0.018), over-the-counter supplement use (C 30%, H 62%, O 22%; p=0.038), and daily medication use (C 51%, H 79%, O 39%, p=0.033). These associations remained when controlling for age, gender, education, and income, with H respondents more likely to be willing to adopt an intervention only if the perceived benefit was an absolute prevention in stone recurrence (logistic regression for: fluid intake, OR 6.5, p= < 0.001; salt intake, OR 7.6, p < 0.001; meat intake, OR 7.5, p < 0.001; avoiding certain foods, OR 5.0, p=0.001; supplement use, OR 4.2, p=0.002; medication use, OR 3.6, p=0.010).
Conclusions: Urolithiasis pts were willing to increase fluid intake, even if perceived reduction of stone recurrence rate was modest. There are racial differences in attitudes towards preventive strategies, with Hispanics indicating lower willingness and higher threshold for adopting lifestyle and therapeutic interventions. Better understanding of underlying reasons for these racial differences can improve stone prevention counseling.