The association between quality of life, intensity of counseling and health literacy amongst patients with nephrolithiasis

Objectives The American Urological Association (AUA) provides guidance on primary prevention for nephrolithiasis; however, patient compliance is often poor. The role of healthy literacy in the primary prevention of nephrolithiasis is not well understood. The goal of this study was to investigate kidney stone formers’ perceptions and understanding of primary prevention for recurrent nephrolithiasis. Methods A cross-sectional web-based survey was administered to a random sample of adult volunteers. Disease specific information was queried for stone formers and all participants were asked a series of questions based on the AUA Metabolic Stone Management Guidelines (2016) regarding primary prevention. Receipt of dietary counseling was categorized by comprehensiveness. Patient quality of life was assessed using the Wisconsin Stone Quality of Life questionnaire (WisQOL). Multivariable linear regression was used to identify predictors of stone-specific health literacy. Results Of the 2,482 participants, 429 (17%) reported prior stone history. Overall accuracy rates ranged from 10–98%. Stone patients with comprehensive counseling had the highest scores, driven by significantly better knowledge on oxalate-specific questions (p < 0.001). Receipt of comprehensive counseling was also associated with lower WisQOL scores across most domains (p < 0.001). Multivariable linear regression showed both increased quality of life (p = 0.017) and receipt of comprehensive counseling (p = 0.032) were independent predictors of increased primary prevention-specific health literacy. Conclusions Overall, correct response rates were poor, especially surrounding dietary oxalates. However, kidney stone formers who received more comprehensive counseling demonstrated both improved stone specific quality of life and health literacy.