Shared appointments show success in kidney stone patients

Among patients with kidney stones, shared medical appointments decrease appointment wait times, increase patient knowledge about stone prevention, and lead to high levels of patient satisfaction, researchers from the University of Wisconsin, Madison reported.

“By grouping together patients new to clinic, we reduced the wait time by half from initial call to scheduled appointment. The number of patient slots in our clinic for new and follow-up patients nearly doubled,” wrote the researchers, led by Stephen Y. Nakada, MD.

A total of 112 patients (mean age, 51±14 years) were seen in 27 shared medical appointments during a 14-month period. New patients were targeted for the shared appointments. The appointments involved a multidisciplinary approach in which multiple providers-urologist and/or nephrologist, registered dietitian, and medical assistant-were brought together in one room.

Appointment wait time decreased from 180±77 days before shared medical appointments to 84±39 days, Dr. Nakada and colleagues reported in The Journal of Urology (2013; 190:1778-84). The number of patients seen per month increased by 43%. Eighty-seven percent of patients rated their overall satisfaction with the shared appointments as excellent or very good, and 90% indicated they would recommend a shared appointment to others.

In terms of knowledge about nutrition and hyperoxaluria, patients in the shared appointments initially scored lower than or about the same as patients who had been seen in individual appointments. Following modifications to the nutrition education curriculum, test scores increased among patients in the shared appointments (p=.021 for difference from controls). Regarding knowledge of nutrition and hypercalciuria, scores among patients in shared appointments were also superior (p=.011), again with improvements in scores apparently related to modifications made in the educational content over time.

“Shared medical appointments can be an efficient way to evaluate and manage new patients for urolithiasis prevention,” the authors concluded. “Patient satisfaction was high and knowledge about prevention was higher than that of patients seen in individual appointments.”

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