Mp31-08 an Intervention to Increase 24-Hour Urine Collection Compliance

Abstract

INTRODUCTION AND OBJECTIVES: Compliance with 24hour urine collections for assessing stone risk is important for assigning appropriate preventive therapy. The objectives of this study were to determine factors associated with compliance and the impact of an intervention introduced to improve this outcome.METHODS: In 2015, the patients in our stone clinic in whom 24 hour urine testing was desired were instructed to contact the vendor (Litholink) and given an instructional sheet provided by this company to arrange for the collections. In 2016, a practice change was implemented and clinic staff sent all urine study requests to the vendor by FAX. During this 2-year period, 24-hour urine studies were ordered by the treating physician in 368 adult stoneformers (SF). Demographic data analyzed included age, gender, race, insurance status, partner status, income, and education. Statistical analysis methods included ANOVA, Fisher's exact test, Chi-squared, and t-test analyses. Compliance was determined based on completion of 24-hour urine collections. Data were analyzed for 2015, 2016, and both years combined (2015/2016).RESULTS: Average age of SF was 49.6 years at time of collection. 47.5% of SF were female. The majority were Caucasians (84.2%) and 15.8% were African Americans. Most patients were adequately insured (90.5%) and the majority had domestic partners (61.4%). Compliance increased after the intervention from 46.9% to 65.1% (p<0.001). Adequate insurance was associated with increased compliance for both years combined (58.3% vs 37.15%, p¼0.017). Partner status and older age were associated with increased compliance in 2015 (54.2% vs 32.8% p¼0.006; 52.9 years vs 47.1 years p¼0.014), but following intervention in 2016 were no longer contributing factors.CONCLUSIONS: A simple intervention increased compliance with performance of 24 hour urine testing by 18% and eliminated health disparities (age, partner status). Inadequate insurance status resulted in poor compliance despite this intervention.

Brain‐specific biomarkers in urine as a non‐invasive approach to monitor neuronal and glial damage

“…While the absolute urine concentration differed between the control and target groups for all four investigated biomarkers, this was only found for NfL and t-tau after calculation of the dilutioncorrected biomarker-creatinine ratio. Because the measured concentration of proteins depends on urine dilution, which is influenced by blood pressure, fluid status and comorbidities, 24-hour urine collection represents the "gold standard" for quantifying protein excretion [22,23]. However, creatinine excretion through the kidney is assumed to be mostly constant under normal circumstances, thus calculation of the protein-creatinine ratio is reported to be an alternative to 24-h collection [19].…”