Open Access

ARTICLE

A survey of patient preferences regarding medical expulsive therapy following the SUSPEND trial

John Roger Bell¹, Kristina L. Penniston¹, Sara L. Best¹, Stephen Y. Nakada^1–3

1 Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
2 Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
3 Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
Address correspondence to Dr. John Roger Bell, University of Wisconsin School of Medicine and Public Health, Department of Urology, 1685 Highland Avenue, Madison, WI 53705-2281 USA

Canadian Journal of Urology 2017, 24(3), 8827-8831.

Abstract

Introduction: Several recent trials have reported limited benefit for medical expulsive therapy (MET) in terms of stone passage rates, analgesic requirements, or need for intervention. We evaluated patient attitudes regarding MET after explaining these new findings.
Materials and methods: Over a 12 week period, an investigator-designed survey was offered to sequential patients during routine appointments in our urologic clinic. A brief summary of the conflicting data for MET was provided. Patients then answered questions about their attitudes toward using MET.
Results: Patients (n = 200; 103 M, 97 F) were 56 ± 14 years old (range 20-103 years) and were mostly being seen for management of kidney stones (88%). Forty-nine percent reported they would try tamsulosin despite the new data; 26% said they would not, and 25% were unsure. Of patients indicating they would take tamsulosin, 35% stated they would also be willing to take steroids. Thirty-five percent of patients said they were willing to pay the full price of tamsulosin if needed. Seventy-one percent said they would prefer to try medical therapy prior to pursuing surgical therapy, again, despite new evidence regarding the efficacy of MET.
Conclusion: In this initial report of patient attitudes about MET after SUSPEND trial results, we found that nearly half of patients would still try MET and that the vast majority of patients prioritize medical over surgical therapy when possible. As new research emerges, ways to translate this information to patients and to assess their attitudes and perceptions should be developed.

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