MP69-18 IMPACT OF HEALTH LITERACY ON URETEROSCOPY OUTCOMES AMONG KIDNEY STONE PATIENTS

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy VII (MP69)1 Apr 2020MP69-18 IMPACT OF HEALTH LITERACY ON URETEROSCOPY OUTCOMES AMONG KIDNEY STONE PATIENTS Naren Nimmagadda*, Caroline Kang, Nicole Miller, S Duke Herrell, and Ryan Hsi Naren Nimmagadda*Naren Nimmagadda* More articles by this author , Caroline KangCaroline Kang More articles by this author , Nicole MillerNicole Miller More articles by this author , S Duke HerrellS Duke Herrell More articles by this author , and Ryan HsiRyan Hsi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000949.018AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Nephrolithiasis is a disease dependent on patients’ self-management; however, little is known on the effect of health literacy on treatment outcomes. We sought to understand the impact of health literacy in this population using the validated Brief Health Literacy Screen (BHLS). METHODS: A retrospective review was conducted of all patients who underwent ureteroscopy for upper tract stones between January and June 2017. Of the 244 patients, BHLS data was available for 105 patients. Demographic, surgical, and postoperative data were collected using the electronic medical record. Opiate usage was obtained from the local controlled substance monitoring database. Univariate and multivariable logistic regression analysis were performed to assess the association of BHLS scores with postoperative complications, stone outcomes, adherence to follow-up and treatment, and opiate use. RESULTS: Mean BHLS score was 13.37 (range 4.09-15.0). 81% of patients attended their initial postoperative visit of which 87.6% maintained subsequent follow-up. On univariate analysis, health literacy did not associate with 30-day complications, ipsilateral stone recurrence or progression, ipsilateral stone events, rates of postoperative follow-up, 24-hour urine collection prescription at initial follow-up, 24-hour urine collection completion by subsequent follow-up, or additional requests for opiates within 30 days. Lower BHLS scores were significantly associated with new chronic opiate usage, defined as obtaining an opiate prescription > 60 days postoperatively without a prior history of chronic usage (OR 0.75, 95% CI 0.59-0.96, p = 0.02). Preoperative opiate prescription patterns were also associated with new chronic opiate usage including increased number of preoperative prescriptions, days supplied, and number of prescribing providers. On multivariable logistic regression, lower health literacy remained a significant predictor of postoperative opiate usage > 60 days (Table 1). CONCLUSIONS: An assessment of health literacy can further screen individuals at risk of postoperative opiate dependence after ureteroscopy. These data identify a need to develop decision-making and counseling tools that account for varying levels of health literacy among kidney stone patients. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1052-e1053 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Naren Nimmagadda* More articles by this author Caroline Kang More articles by this author Nicole Miller More articles by this author S Duke Herrell More articles by this author Ryan Hsi More articles by this author Expand All Advertisement PDF downloadLoading ...