WeChat-Based Digital Therapy to Improve Fluid Intake in Kidney Stone Patients: Study Protocol

Developing and Evaluating a WeChat-based Digital Therapeutic Intervention To Enhance Postoperative Fluid Adherence In Patients With Urinary Calculi: Study Protocol

The goal of this clinical trial is to learn Whether the WeChat-based applet works to prevent urinary calculi for postoperative patients. The main questions it aims to answer are:

Dose the WeChat-based applet intervention increase the amount of fluid intake and urine output? Researchers will compare the WeChat-based applet intervention to a usual care to see if the WeChat-based applet works to prevent urinary calculi occurence.

Participants will:

1. Using the WeChat-based applet or a placebo every day for 3 months
2. Keep a record of their fluid intake, urine output, number of urinary calculi recurrence

The study outcomes will be reported to adhere to the guidelines outlined in the Consolidated Standards of Reporting Trials (CONSORT) 2010 statements. Reporting measures of central tendency (mean, median) and dispersion (standard deviation, range) for continuous variables, as well as frequencies and percentages for categorical variables. Statistical tests such as a t-test and chi-square test will be employed for continuous and categorical variables within two groups. The principal analysis will compare the fluid intake volume between the intervention and control groups using the t-test. Secondary outcomes such as The Wisconsin Stone Quality of Life Questionnaire (WISQOL), Patient Health Questionnaire-9 Items (PHQ-9), International Physical Activity Questionnaire (IPAQ-SF ) and The Electronic Health Literacy Scale (eHEALS) will use repeated measures of Analysis of Variance (ANOVA) since they are measured over time and between two groups. If necessary, subgroup analyses will be conducted to explore whether the effect of the intervention varies across different demographic or clinical subgroups. Intention-to-treat (ITT) analysis will be used to assess the impact of the treatment and its generalizability. A significance level of p < 0.05 will be utilized to determine statistical significance, and all data analysis procedures will be conducted using the SPSS (Statistical Product and Service Solutions) 26.0 software package.The researcher is granted access to the complete trial dataset, with a contractual agreement established with the statistician to manage the data confidentially in accordance with the research protocol.

Inclusion Criteria:

• With a history of urinary calculi and having received urolithiasis surgery before
• 24-hour fluid intake < 2500 ml
• Age ≥ 18 years old
• Able to use WeChat daily
• Able to read and write informed consent

Exclusion Criteria:

• Participants with obstructive uropathy, chronic urosepsis, renal failure, and renal tubular acidosis
• Participants with congestive heart failure, psychiatric conditions, pregnancy, and primary hyperparathyroidism
• Participants experienced complicated urolithiasis surgery.
• History of recurrent UTI (urinary tract infection) (>3/year)
• Medication use increases stone risk.
• Participants with physical disabilities