The Effect of the COVID-19 on Patient Preferences and Decision Making for Obstructive Urinary Stone Interventions

NCT04924790 — Unknown, 158 participants, Ankara Training and Research Hospital

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The Effect of the COVID-19 Pandemic on Patient Preferences and Decision Making for Obstructive Urinary Stone Interventions

RegistryNCT04924790
StatusUnknown
Study typeObservational
Enrollment158 (Estimated)
SponsorAnkara Training and Research Hospital (Other)
ConditionsUrinary Stone, Urinary Calculi, Covid19
InterventionsCOVID-19 Pandemic (Behavioral)
Datesstart 2021-09-01, primary completion 2022-05-01 (estimated), completion 2022-08-01 (estimated), first posted 2021-06-14, last updated 2022-03-02
Locations1 site in Turkey (Türkiye)

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-Summary

In this study, the investigators aim to evaluate the intervention preferences of patients with obstructive urinary stones who are suitable for operation during the COVID-19 pandemic. The secondary aim is to compare and evaluate the preferences compared to the pre-pandemic period and to gain a perspective on how the decision-making process has changed from the patient's point of view. Thus, by trying to understand how the COVID-19 epidemic affects the treatment choice decisions of patients, the investigators aim to determine how the state of anxiety changes these preferences.

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+Detailed description

The transformative impact of the COVID-19 pandemic on healthcare use remains an open question. At the onset of the pandemic, policies to limit transmission were adopted, including stay-at-home decisions, social distancing, and postponing elective surgery. Such policies have contributed to reduced emergency room admissions, increased concern about COVID-19, and hospital systems have had to prioritize emergency intervention.

Obstructive urolithiasis is a clinical condition that usually causes severe flank pain and causes emergency admission. It is still unclear how the epidemic impairs the treatment pathways of the obstructive urolithiasis that contributes to the emergency room visit. Treatment options range from observation and medical expulsive therapy to operative interventions such as extracorporeal shock wave lithotripsy, ureteroscopy and percutaneous nephrolithotomy. Patient preference, stone characteristics and comorbidities are of great importance in decision making. However, since obstructive ureteral stones that cannot be resolved spontaneously can cause irreversible renal parenchymal damage and obstructive pyelonephritis in a short time, the option of operation is always prioritized.

Patient perspectives on how COVID-19 is changing healthcare use and decision-making still remain unclear. In our study, the investigators plan to record patient treatment preferences by explaining in detail how and where treatment options will be applied, success and complication rates for patients diagnosed with obstructive urolithiasis and suitable for intervention in the outpatient clinic. In addition, when evaluating patient preferences, the investigators foresee to determine how the COVID-19 pandemic process has changed compared to before. It is planned that our study will have a patient-centered approach with detailed oral and written information in outpatient clinic conditions.

+Arms and interventions

ArmTypeInterventionsDescription
COVID-19 Urinary StoneBehavioral: COVID-19 PandemicPatients diagnosed with obstructive urinary stones in the COVID-19 period
PreCOVID-19 Urinary StoneBehavioral: COVID-19 PandemicPatients diagnosed with obstructive urinary stones in the preCOVID-19 period
  • COVID-19 Pandemic (Behavioral): Comparison of the intervention preferences of patients diagnosed with obstructive urinary stones in the urology clinic and recommended for intervention during and before COVID-19

+Outcome measures

Primary outcomes

  • Rates of interventions preferred by patients [6 months]: Rates of interventions preferred by patients for obstructive urinary stones

+Eligibility

Sex: All, ages: 18 Years to 90 Years

Inclusion Criteria:

* Obstructive Urinary Stone

Exclusion Criteria:

* Previous operation for urinary stone
* Presence of bladder stone
* Presence of stent in the ureter
* Previous radiotherapy to the pelvic and abdominal region
* Pregnancy
* Neurological disease

+Locations (1)

FacilityCityCountryStatus
Ankara Training and Research HospitalAnkara, AltindagTurkey (Türkiye)Recruiting

+Publications

  • Jiang T, Osadchiy V, Weinberger JM, Zheng MH, Owen MH, Leonard SA, Mills JN, Kachroo N, Eleswarapu SV. Impact of the COVID-19 Pandemic on Patient Preferences and Decision Making for Symptomatic Urolithiasis. J Endourol. 2021 Aug;35(8):1250-1256. doi: 10.1089/end.2020.1141. Epub 2021 Mar 4. PMID 33478351
  • Campi R, Tellini R, Grosso AA, Amparore D, Mari A, Viola L, Cocci A, Polverino P, Checcucci E, Alessio P, Fiori C, Minervini A, Carini M, Porpiglia F, Serni S. Deferring Elective Urologic Surgery During the COVID-19 Pandemic: The Patients' Perspective. Urology. 2021 Jan;147:21-26. doi: 10.1016/j.urology.2020.09.015. Epub 2020 Sep 24. PMID 32979378
  • Lee EH, Kim SH, Shin JH, Park SB, Chi BH, Hwang JH. Effects on renal outcome of concomitant acute pyelonephritis, acute kidney injury and obstruction duration in obstructive uropathy by urolithiasis: a retrospective cohort study. BMJ Open. 2019 Nov 3;9(11):e030438. doi: 10.1136/bmjopen-2019-030438. PMID 31685503

+Investigators

  • Ali Kaan Yildiz, Principal investigator, Ankara Training and Resarch Hospital