Health education is important for improving patients’ treatment adherence, thereby reducing morbidity. Face-to-face communication is insufficient nowadays, and online interaction can improve patient–physician communication and education. 
Objective: We designed a free interactive counseling program in a mobile communication application for patients receiving indwelling double-J ureteric stents (DJs) after ureterorenoscopic lithotripsy (URSL) and evaluated satisfaction with the program and its influence on patients’ subjective experience of DJ-related symptoms.

We designed a free interactive counseling program based on the free module provided by the mobile communication application Line, which described symptoms associated with and post-discharge self-care for DJs and emphasized the importance of timely DJ removal. Patients could interact with the program for any concerns regarding their DJs after discharge. We retrospectively collected patients with indwelling DJs after URSL at our hospital from August 1st, 2019 to November 30th, 2019. All patients received face-to-face DJ education medical staff before discharge, and an additional “Ureteric Stent Interactive Program” was provided for willing patients. All patients rated the severity of their DJ-related symptoms and the interactive program users rated their satisfaction with the interactive counseling program on a five-point scale before DJ removal. We evaluated the effect of the program on the severity of DJ-related symptoms and the possible factors associated with satisfaction with the program.

We included 70 patients; 50 had routine education by medical staff and elected to have additional interaction through the interactive counseling program, while the remaining 20 received routine education by medical staff only. The patients in the program group were significantly younger (age <60 years: 74% versus 15%, P <.001), had higher education levels (40% versus 5%, P =.004), and reported more severe gross hematuria (66% versus 15%, P <.001) than did those in the medical-staff group. No differences were observed for other DJ-associated symptoms. On multivariate analysis, severe gross hematuria was significantly associated with age below 60 years (odds ratio 6.704, P =.003, 95% CI 1.898–23.673) and the use of the program (odds ratio 6.63, P =.02, 95% 1.374–31.989). All 50 patients in the program group reported being satisfied (32%) or very satisfied (68%) with the program. Patients over 60 years were significantly more satisfied with the interactive counseling program (35.5% versus 6.3%, P =.04). Education level, the severity of DJ-associated symptoms, and the recognition of the necessity of DJ removal were not significantly associated with the degree of satisfaction.

The use of a free interactive counseling program in mobile communication application resulted in high patient satisfaction, especially in elderly patients. Younger patients with higher education levels were more likely to adopt this new form of communication, which improved their knowledge of DJ-associated symptoms.

This study demonstrates the benefits interactive application has for educating patients regarding their health through.

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