Patient compliance to dietary recommendations: tips and tricks to improve compliance rates

Urinary stone disease continues to be a public health problem with growing incidence and recurrences. Recurrence is nearly detected in 50% of the patients within 5 years after the first episode. However, stone recurrence rates can be reduced to a certain extent. The American Urological Association (AUA) and the European Urological Association (EAU) guidelines advice dietary, fluid intake, and medical treatment to prevent or minimize stone recurrence. However, studies have shown that compliance to dietary and fluid intake recommendations is low. Beside this, nutritional evaluation of the patients is sufficient. Using food frequency questionnaires (FFQs), 24 h recall methods (short, individual-oriented, and easily applicable) or mobile apps can be used. In addition, cooperation with registered dietitians (RD) and planning tailored dietary programmes may have positive effect on compliance. Providers who give dietary advices should improve their knowledge about the topic and communication skills to create a patient-provider trust relationship. Simplifying the advices (shorter lists, applicable advices), spending more time, and giving education until being sure for patients' understanding with regular remindings may improve adherence. Moreover, patients increased awareness and knowledge about dietary advices are beneficial. Smart devices for fluid uptake or urine pH monitoring, mobile apps or web-based portals, and telemedicine applications can be used to maintain the compliance on dietary advices. Compliance with dietary modifications and fluid intake recommendations can be well achieved by individualized evaluation/close follow-up and the elimination of the problems limiting the patient compliance.