title: Parent compliance: a bad predictor of resolution and a problem in the application of EAU guidelines on vesicoureteral reflux in children.
abstract: Primary vesicoureteral reflux (VUR) is a controversial pathology. Current management of VUR is ruled by EAU guidelines elaborated in 2012. They defined and analyzed the risk factors and enunciated three risk groups, developing the initial treatment indications. Continuous antibiotic prophylaxis (CAP) is recommended as the initial treatment option in patients classified in moderate-risk group without low urinary tract disorder. The compliance with medication use is a concern for using CAP. The aim of the present study is to quantify the compliance of the parents of VUR patients, to analyze its impact on treatment and the applicability of EAU guidelines in our patients. This is a 4-year prospective study, which includes 202 patients aged between 1 and 174 months, diagnosed with primary VUR without LUTD. To quantify parent compliance with treatment, an algorithm was developed. Out of 202 children, 60.9% were girls. A rate of 54% patients was declared cured. In terms of compliance, incompliant patients tend toward worsening (p = 0.0001), most of them being unfollowed. Logistic regression demonstrated that the evolution of children with VUR is dependent on compliance. In conclusion, parent's compliance must be considered in EAU guidelines application, being a negative predictive factor in VUR resolution.
authors.affiliation: University of Medicine and Pharmacy Targu Mures, Targu Mures, Mures, Romania. radualexandruprisca@gmail.com.
authors.forename: Radu Alexandru
authors.initials: RA
authors.lastname: Prisca
authors.affiliation: University of Medicine and Pharmacy Targu Mures, Targu Mures, Mures, Romania.
authors.forename: Horea
authors.initials: H
authors.lastname: Gozar
authors.affiliation: University of Medicine and Pharmacy Targu Mures, Targu Mures, Mures, Romania.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Prisca
authors.affiliation: University of Medicine and Pharmacy Targu Mures, Targu Mures, Mures, Romania.
authors.forename: Cosmin
authors.initials: C
authors.lastname: Moldovan
authors.affiliation: University of Medicine and Pharmacy Targu Mures, Targu Mures, Mures, Romania.
authors.forename: Angela
authors.initials: A
authors.lastname: Borda
mesh_terms: D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005060:Europe; D005260:Female; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D010290:Parents; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014567:Urography / Q000379:methods; D013520:Urologic Surgical Procedures / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Guidelines; Parent compliance; Primary vesicoureteral reflux