Christina Ching, MD, on overcoming barriers to follow-up after pediatric stone surgery

In a recent interview, Christina B. Ching, MD, of Nationwide Children’s Hospital in Columbus, Ohio, shared key takeaways from the study, “Predictors of follow-up of pediatric stone patients after surgical intervention.”

Data from the study showed that 74.9% of patients in the study attended a post-operative visit. Having public insurance and living in a single-parent household, which may be indicators of low socioeconomic status, were associated with a lower rate of follow-up after pediatric kidney stone surgery (P < .01 and P = .02, respectively). Patients who were seen in the urology clinic prior to their procedure were more likely to comply with follow-up (P = .02).

According to Dr. Ching, these findings underscore the importance of establishing a relationship with a urologist prior to surgery and speaking directly with patients about barriers they might be facing. One solution, she recommends, could be offering and sharing information about evening clinic hours that may be easier for working, single parents to attend.

She also indicated a need to better counsel patients about why they are being asked to return to the clinic following the procedure in the first place, as many may not understand the need to do so.

Additional data from the study looked at the rates of completed post-operative imaging and 24-hour urine testing. Data showed that the rate of completed imaging was around 80%. Patients with a larger total stone burden were more likely to undergo ordered imaging (P < .01).

However, although recommended in American Urological Association guidelines, just under 70% of patients had an order for urine testing, and less than 50% underwent testing when they were ordered. According to Dr. Ching, this indicates a need for physicians to both follow the guidelines and assess why the completion rate is so low among patients.