Penn State Health Milton S. Hershey Medical Center
Introduction: Shared medical appointments (SMA), or group visits, provide an efficient way to improve patient care and education to patients with chronic diseases such as kidney stones. Metabolic evaluation for the prevention of kidney stones requires extensive patient education and a multidisciplinary approach is preferable to deliver both medical and dietary therapy. However, it can be time-consuming to deliver quality care within the constraints of individual appointments. The purpose of this study was to determine the feasibility and acceptability of SMA utilizing telehealth medicine for kidney stone prevention.
Methods: Patients with a history of recurrent kidney stones who were agreeable to metabolic evaluation for kidney stone prevention as well as participating in a SMA telehealth visit were enrolled (November 2020- October 2021). Patients signed consent to participate in this setting. SMA telehealth visits were performed via Zoom platform led by both a dietician and urologist. Sessions included both group education as well as individualized discussion of results and treatment plans. After the visit, patients completed an electronic questionnaire assessing patient satisfaction, quality of education and acceptability of SMA telehealth visits (5-point Likert scale).
Results: 28 patients with a history of recurrent kidney stones were seen in SMA telehealth visits for new metabolic stone evaluation and 14 patients responded to the electronic questionnaire (age = 47.4 ± 17.0 years; 79% female; 50% response rate). Sessions lasted approximately 1-hour and typically included 3-4 patients, which compared to 1.5 patients being seen during typical individual appointments during the same timeframe. The quality of education was rated highly by the majority of patients for both general education on kidney stones /dietary strategies and individualized education on risk factors/ diet recommendations (86% and 79% respectively). The overall patient satisfaction was positive for the majority of patients (86%) and the majority would recommend this type of visit to a family member or friend (79%). However, 21% of patients would have preferred an individual appointment.
Conclusions: We found that SMA utilizing telehealth medicine for education of kidney stone prevention and review of individual metabolic evaluations is both feasible and acceptable to patients. Overall patient satisfaction was positive for the majority of patients and patient education was highly rated. Furthermore, SMA telehealth visits provide clinicians with an efficient approach to provide improved patient education for kidney stone prevention.