Pain-focused stone patients less likely to reach treatment goals

Patients with kidney stones who rank their pain at the maximum level on a 100-point scale or whose number-one goal for treatment is to relieve pain are less likely to reach their treatment goals than other patients undergoing kidney stone treatment, a recent study found.

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Chicago-Patients with kidney stones who rank their pain at the maximum level on a 100-point scale or whose number-one goal for treatment is to relieve pain are less likely to reach their treatment goals than other patients undergoing kidney stone treatment, a recent study found.

Nicholas Koch, a medical student at the University of North Carolina School of Medicine in Chapel Hill, sought to determine how patients with symptomatic kidney stones evaluate their treatment outcomes after kidney stone surgery. Typically, these outcomes are assessed by physicians and are based on whether the patient has gained complete relief of their kidney stone burden. However, this approach doesn’t consider the patient’s expectations for symptom relief and what the patient would consider to be a successful outcome.

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Under the direction of Davis Viprakasit, MD, Koch worked with the UNC department of biostatistics and UNC urologists to modify the Patient-Centered Outcomes Questionnaire to dig deeper. The goal: to explore the differences in patient-defined outcomes between kidney stone patients who ranked pain control as extremely important and those who did not.

Modified questionnaire used for study

Fifty-nine symptomatic patients undergoing ureteroscopic or percutaneous stone surgery participated and completed the modified, stone-specific questionnaire before surgery and during their routine postoperative follow-up. The survey measured patients’ expected, desired, and success levels of pain symptoms following surgery. Koch then compared responses from patients who were highly pain focused and those who were less so.

Sixty-eight percent of the respondents were women. The average age of respondents was 54.9 years. Among those surveyed, 69% had a history of stone disease. The percentage of pain-focused patients who had previously dealt with kidney stones was significantly higher than non-pain-focused patients with a history of disease.

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