Improving the compliance of the recurrent stone-former

OBJECTIVE To provide an overview of aspects of compliance by the recurrent stone-former, and to give recommendations for its improvement. About half of all stone-formers have one recurrence during their lifetime. To avoid recurrent stone formation it is necessary to use metaphylaxis, based on individual risks. However, all general and specific efforts are meaningless if patients are not willing or are incapable of following the proposed therapy in the long-term. METHODS PubMed was searched for articles on urolithiasis, metaphylaxis, compliance and adherence, and relevant papers were reviewed. RESULTS Compliance is a multidimensional phenomenon which is determined by the interaction of different factors, i.e. social and economic, therapy-related, patient-related, condition-related, and healthcare team and system-related factors. Subsequently there are several different interventional possibilities at the urologist's disposal to effect better compliance by the patient. CONCLUSIONS The treatment and metaphylaxis of the recurrent stone-former present a particularly pertinent challenge. Patient compliance has an immense influence on the success of the treatment with respect to metaphylaxis, which is the decisive factor for preventing stone recurrence.