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首页> 外文期刊>Urology practice. >Patient Satisfaction and Clinical Efficacy of an Advanced Practice Provider Stone Prevention Clinic
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Patient Satisfaction and Clinical Efficacy of an Advanced Practice Provider Stone Prevention Clinic

机译：先进实践提供者石预防诊所的患者满意度和临床疗效

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Introduction: The benefits of a multidisciplinary stone prevention clinic are well established. However, the outcomes of advanced practice provider integration into this model have not been reported. Our goal was to assess the feasibility of an advanced practice provider managed stone prevention clinic.Methods: High risk kidney stone patients were evaluated by an advanced practice provider and registered dietitian. Medical and dietary interventions were formulated based on medical and dietary history, labs and imaging. Post-intake surveys assessed patient satisfaction and educational impact. Survey results, stone risk parameters and acute stone events were retrospectively reviewed. Paired samples t-tests were used to assess changes in 24-hour urine parameters.Results: We followed 77 patients over an average of 4.34 visits (750+-464 days). Of the 63 surveys completed 100% found their visit helpful and 98.4% would recommend the clinic. Of the 65 patients with multiple 24-hour urine studies significant reductions were seen in stone supersaturation profiles for uric acid (54.2%, p <0.01) and calcium phosphate (31.8%, p=0.04). Supersaturation profiles for uric acid, calcium phosphate and calcium oxalate decreased with each followup visit. Number of registered dietician appointments was associated with reduced supersaturation of calcium oxalate (-2.29, p=0.04). Number of advanced practice provider appointments was associated with reduced supersaturation of uric acid (-0.34, p=0.02). In all, 15 patients experienced an acute stone event and 8 patients had 1 or more emergency room visit.Conclusions: The implementation of an advanced practice provider managed stone prevention clinic is feasible in the community setting. This is supported by positive feedback, educational impact and reductions in stone risk parameters.
机译：导言：多学科结石预防诊所的好处是众所周知的。然而，高级实践提供者融入该模型的结果尚未报告。我们的目标是评估高级实践提供者管理的结石预防诊所的可行性。方法：由高级实践提供者和注册营养师对高危肾结石患者进行评估。医疗和饮食干预措施的制定基于医疗和饮食史、实验室和影像学。摄入后调查评估患者满意度和教育影响。回顾性分析调查结果、结石风险参数和急性结石事件。配对样本t检验用于评估24小时尿液参数的变化。结果：我们对77名患者进行了平均4.34次随访（750+-464天）。在完成的63项调查中，100%的人认为他们的访问有帮助，98.4%的人会推荐诊所。在进行多次24小时尿液检查的65名患者中，尿酸（54.2%，p<0.01）和磷酸钙（31.8%，p=0.04）的结石过饱和度显著降低。尿酸、磷酸钙和草酸钙的过饱和曲线随着每次随访而降低。注册营养师预约次数与草酸钙过饱和度降低有关（-2.29，p=0.04）。预约高级执业医师的次数与尿酸过饱和度降低有关（-0.34，p=0.02）。总共有15名患者经历了急性结石事件，8名患者进行了一次或多次急诊。结论：在社区环境中实施由高级实践提供者管理的结石预防诊所是可行的。这得到了积极反馈、教育影响和降低结石风险参数的支持。

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