The impact of smart technology on adherence rates and fluid management in the prevention of kidney stones

Wright, Harlan I.; Alshara, Luay; DiGennaro, Heidi; Kassis, Yvonne El; Li, Jianbo; Monga, Manoj; Calle, Juan; Sivalingam, Sri

doi:10.1007/s00240-021-01270-6

Cited by 13 publications

(9 citation statements)

References 20 publications

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“…This was illustrated by participants reporting that adherence to self‐management waned over time as the immediate response to KSD faded, in terms of assessment and treatment of the acute episode, providing insights into adherence barriers for patients in this study. Similarly, recent research suggests that adherence remains low at follow‐up, despite initial increases in such fluid intake behaviour (Wright et al, 2022). Patients' perspectives, elicited in this study regarding the reduced need for sustained self‐management provides important information that emphasizes the need for health care providers to continuously emphasize patients' agency in the management of their KSD.…”

Section: Discussionmentioning

confidence: 93%

‘Like a ticking time bomb’: A qualitative study exploring the illness experiences of adults with kidney stone disease

Néill

Richards

Hennessey

et al. 2023

British J Health Psychol

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ObjectiveKidney stone disease (KSD) is a common, complex and painful urological condition, but how patients make sense of and respond to the challenges of KSD is poorly understood. Using the common‐sense model of illness self‐regulation (CSM‐SR), we aimed to explore the illness experiences of individuals with KSD.DesignA qualitative design using individual semi‐structured interviews.MethodsThirty‐three patients with KSD attending outpatient urology services participated in interviews informed by the CSM‐SR. Data were analysed using reflexive thematic analysis. Themes were mapped onto the domains of the CSM‐SR.ResultsFive main themes were generated, broadly echoing domains within the CSM‐SR: (1) making sense of KSD, (2) normality paused, (3) the psychological burden of KSD, (4) the tensions of managing KSD, and (5) improving understanding of KSD. Additionally, findings suggested that partners' perceptions of KSD were an additional contextual factor that informed patients' own perceptions and management of KSD. Participants appraised initial KSD symptoms as indicative of a serious health threat. Diagnosis brought some relief, however, KSD wielded multi‐dimensional impacts on patients' perceptions, self‐management and well‐being. Anxiety, including fear of KSD recurrence, and low mood were common psychological burdens across narratives.ConclusionThe majority of the themes identified were commensurate with an extended CSM‐SR. This model has utility in informing how patients perceive and manage KSD. Examining patients' KSD representations and routinely assessing for psychological distress may be of benefit to improve health outcomes for this patient group.

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Section: Discussionmentioning

confidence: 93%

‘Like a ticking time bomb’: A qualitative study exploring the illness experiences of adults with kidney stone disease

Néill

Richards

Hennessey

et al. 2023

British J Health Psychol

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“…Participants were randomized into three groups: routine counseling regarding fluid intake, counseling and a smartphone app to keep track of water intake goals, and counseling and a smart water bottle that provided feedback on fluid consumption and tracked hydration progress. The study found no difference between the groups in the mean 24hr urine output volume or at 12-month follow-up [28 ▪ ]. Of note, the patients in the smart water group were not targeted with any BCTs apart from the feedback provided by the smart water bottle app and compliance only factored in completion of the 24-h urine, not use of the bottle.…”

Section: Emerging Technologiesmentioning

confidence: 85%

“…Wright et al . [28 ▪ ] conducted a study examining the use of smart water bottles and their impact on 24-h urine. Participants were randomized into three groups: routine counseling regarding fluid intake, counseling and a smartphone app to keep track of water intake goals, and counseling and a smart water bottle that provided feedback on fluid consumption and tracked hydration progress.…”

Section: Emerging Technologiesmentioning

confidence: 99%

“…PUSH is a randomized controlled trial that aims to leverage hydration monitoring via smart water bottles with multiple BCTs to increase and maintain the recommended daily fluid intake volume [29 ▪ ]. In contrast to the study by Wright et al [28 ▪ ], this trial examines the use of a multicomponent behavioral intervention program, not just the use of a smart water bottle in isolation. Here, both the control and intervention arms will receive a smart water bottle to monitor fluid intake.…”

Section: Emerging Technologiesmentioning

confidence: 99%

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Leveraging behavioral modification technology for the prevention of kidney stones

Aksenov,

Streeper,

Scales

2023

Current Opinion in Urology

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Purpose of review The purpose of this review is to examine the use of technology to help promote and maintain behaviors that decrease stone recurrence. Recent findings Behavior change is a complex process with various interacting components. Recent developments have sought to utilize technology in combination with behavioral change techniques to promote behavior that lowers stone recurrence risk. Smart water bottles are becoming a popular way to accurately measure fluid intake with variable impact on adherence to the recommended daily fluid intake. Mobile apps have also been explored as a method to improve fluid intake. Interventions that combine smart water bottles, mobile apps, and behavioral change techniques have shown the most promise in promoting increased daily fluid intake. Other technologies, such as smart pill dispensers and hydration monitors, have potential applications in promoting behavioral change for stone disease but have yet to be evaluated for this purpose. Summary There is a limited number of studies exploring technology as a means to promote and maintain behaviors that decrease urinary stone recurrence. Future research is needed to elucidate how to maximize the potential of these technologies and better understand which behavioral change techniques best promote habit formation for the prevention of stones.

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“…48 Recent studies assessing smart technology including smart water bottles and associated digital applications have shown the accuracy of these technologies to measure fluid intake, however the impact on urine output may be similar to counseling. [56][57][58] A systematic review showed that most interventions can improve fluid intake by approximately 500mL, with the most effective strategies being instruction, and self-monitoring using urine dipstick or 24-hour urine volume. 59 Counseling regarding fluid intake should clearly state the risk reduction associated with increased fluid intake, explore barriers to fluid consumption such as occupational barriers, taste factors related to water, and urinary voiding difficulties such as overactive bladder and bladder outlet obstruction.…”

Section: General Dietary Measuresmentioning

confidence: 99%

Update – 2022 Canadian Urological Association guideline: Evaluation and medical management of the kidney stone patient

Bhojani

Bjazevic

Wallace

et al. 2022

CUAJ

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with a high risk of recurrent stone disease undergo metabolic evaluation by any physician. 9 81% of patients interviewed would prefer to take prophylactic medication than undergo another stone episode, and 92% of respondents preferred medication to undergoing surgery. 10 Although patients indicate they would be interested in using medication to prevent future stones, compliance studies suggest otherwise. Close to 50% of patients prescribed pharmacological prevention were non-compliant, especially those on potassium citrate. 11 This data stresses the importance of a comprehensive metabolic assessment with implementaiton of individualized prevention strategies. With directed therapy and proper patient education, patient compliance and therapeutic success may be optimized.The economic burden of recurrent stone disease is also significant. Estimates of direct costs for patient care and the indirect costs related to lost work time exceed $5 billion USD. 12,13 Given the rising rates of obesity and diabetes and their association with stone formation, the cost of managing stone disease is expected to increase to 1.24 billion dollars yearly in the US by 2030. 14 This guideline is an update of the 2016 document and aims to identify patients at heightened risk of stone recurrence, to outline the required investigations to assess these patients, and to provide contemporary advice on dietary and medical interventions of proven benefit in the Canadian context. This current guideline addresses the evaluation and medical prophylaxis of upper urinary tract stones and not bladder stones. Literature reviewThe updated content included in this document is based on a review of the English language literature. A PubMed search was conducted encompassing the period from January 1, 2015 to July 1, 2021 to include the following terms: "nephrolithiasis", "urolithiasis", "kidney stone", "renal stone", or "urinary stone". In total, 11,640 article titles were reviewed and 293 were identified as potentially relevant for inclusion in the literature assessment for this guideline update. Management recommendations were modified if needed based on the most current literature since the last guideline was published in 2016. Studies were evaluated and recommendations made based on Oxford levels of evidence and grades of recommendation as per the CUA Guidelines Committee's directive. 15

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The impact of smart technology on adherence rates and fluid management in the prevention of kidney stones

Cited by 13 publications

References 20 publications

‘Like a ticking time bomb’: A qualitative study exploring the illness experiences of adults with kidney stone disease

‘Like a ticking time bomb’: A qualitative study exploring the illness experiences of adults with kidney stone disease

Leveraging behavioral modification technology for the prevention of kidney stones

Update – 2022 Canadian Urological Association guideline: Evaluation and medical management of the kidney stone patient

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