Proposed Topic (Most preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Proposed Topic (Second preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Ng SL(1), Chun SCC(2), Chan HK(3), Tse YB(4), Ha YF(3), Wong PY (3), Ho BSH (5), Ng ATL(6)
Affiliation :
(1) Urology Nurse Consultant, Queen Mary Hospital, HKWC. (2) Research Assistant, The University of Hong Kong. (3) Registered Nurse, Queen Mary Hospital (4) Associate Nurse Consultant, Queen Mary Hospital, HKWC. (5) Urologist Consultant, Queen Mary Hospital, HKWC (6) Division Head, Queen Mary Hospital, HKWC
Introduction :
Renal stone is one of the commonest conditions in urology. Nearly 1 in 11 individuals in United States have urinary tract stone. The prevalence rates for renal stones vary from 1% to 20%. Moreover, the recurrence rate within 5 years is 30%-40%. In the past, the recurrent renal stone formers were instructed to save urine for pH on the day of follow-up at stone clinic. The urine was sent to laboratory for formal result and at the same time, nursing staff using pH paper to have an immediate pH result. Medication for prevention or dissolution of calcium oxalate / uric acid stone was prescribed based on the urine pH result using the pH paper. However, many clinical studies showed the pH paper has significant deviation with the readings from laboratory making it not sufficiently reliable for guiding clinical decision-making for recurrent stone formers. Thus, some patients needed to be called back to the clinic for medication adjustment if there were discrepancy on urine pH value from laboratory and the urine pH paper.
Objectives :
The application of a validated hand-held urine pH meter to check the urine pH for the urinary tract stone formers during follow-up to receive prompt treatment and shorten hospital journey in an outpatient setting.
Methodology :
Patients aged >= 18, with recurrent renal stones are instructed to save urine pH during the follow-up. In the past, the urine pH value was measured by urine pH paper plus sending to the laboratory for formal result. Patients are required to go back to hospital for mediation adjustment if needed. Nowadays, in QMH stone clinic, a validated urine pH meter is used on recurrent stone formers during their follow-up. The result of urine pH can be retrieved immediately. Urologist can prescribe the medication safely and appropriately without delay.
Result & Outcome :
There were 1128 patients who attended stone clinic from 1st April to 30th September 2023. There were 116 patients (10.3%) required medications for stone prevention and dissolution. The mean age of the patients was 54.2 +/- 7.5 years. By using the validated pH meter, patients can receive medication immediately after medical consultation. It can directly shorten the patients’ hospital journey and achieve win-win situation between healthcare professional in specialist outpatient clinic and patients. Conclusion Monitoring of urinary pH is (1) an important part of the assessment of patients with recurrent renal stones; (2) a useful marker in the treatment of urolithiasis. A validated urine pH meter is simple and easy to use in stone clinic. Recurrent stone formers can be benefit from shorten hospital journey with prompt disease management.
