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Clinical Nutrition

Factors associated with patient recall of individualized dietary recommendations for kidney stone prevention

European Journal of Clinical Nutrition volume 70, pages 1062–1067 (2016)Cite this article

Subjects

Abstract

Background/Objectives:

Dietary approaches to preventing the recurrence of idiopathic calcium-containing kidney stones are effective. However, a lifelong commitment to prevention is challenging for many patients. Multiple patient factors likely account for compliance and adherence with dietary recommendations. We examined patients’ recall and compliance with dietary recommendations provided during clinical evaluation.

Subjects/Methods:

Of 275 patients who received dietary recommendations from a dietitian, 112 completed an investigator-designed survey querying their recollection of dietary recommendations. Patients’ responses were compared with the recommendations actually provided as entered in patients’ medical records.

Results:

Patients (62% male, 56±13 years; 38% female, 52±14 years) were provided 3.4±1.1 recommendations (min–max, 1–6) and recalled 67% of recommendations. Highest recalls were for (i) lower meat/fish/poultry intake, (ii) higher fluid intake and (iii) lower sodium (⩾68% for all). Lowest recalls were for weight loss, using citrus juices and increasing fruits/vegetables (⩽61% for all). Forty-seven percent of patients given 1–3 recommendations recalled 100%, whereas only 23% of patients provided >3 recommendations did so (P=0.011). Even though 38% of patients reported some difficulty following dietary recommendations, nearly all (91%) said that they were willing to continue following them.

Conclusions:

Higher patient recall is associated with ⩽3 dietary recommendations. Patient recall of recommendations that were not actually provided (‘false recall’) may contribute to reduced recall and confusion about the most important dietary strategies to reduce their stone risk. Accordingly, providers should prioritize the most important dietary recommendations, reserving those less important for follow-up, and address any confusion patients have from information received prior to evaluation.

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Authors and Affiliations

  1. Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    K L Penniston, M L Wertheim & S Y Nakada

  2. Department of Clinical Nutrition Services, University of Wisconsin Hospital and Clinics, Madison, WI, USA

    K L Penniston & M L Wertheim

  3. Department of Medicine-Nephrology Section, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    S Y Nakada & R A Jhagroo

Authors
  1. K L Penniston
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  2. M L Wertheim
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  3. S Y Nakada
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  4. R A Jhagroo
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Correspondence to K L Penniston.

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The authors declare no conflict of interest.

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Author contributions

KLP formulated the clinical research question, designed the protocol, analyzed data and wrote the manuscript. KLP provided medical nutrition therapy to patients as part of her responsibilities as registered dietitian nutritionist in the Metabolic Stone Clinic. MLW developed the survey and carried out correspondence with patients. She assisted with data analysis and the writing of the manuscript. SYN assisted with the formulation of the clinical research question, project design, and data interpretation and analysis. RAJ assisted with the formulation of the clinical research question and assisted with data interpretation and analysis. RAJ provided clinical care to patients as part of his responsibilities as nephrologist and director of the Metabolic Stone Clinic.

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Penniston, K., Wertheim, M., Nakada, S. et al. Factors associated with patient recall of individualized dietary recommendations for kidney stone prevention. Eur J Clin Nutr 70, 1062–1067 (2016). https://doi.org/10.1038/ejcn.2016.79

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  • DOI: https://doi.org/10.1038/ejcn.2016.79

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