PURPOSE: Nonsurgical treatment of vesicoureteral reflux requires antibiotic prophylaxis and long-term surveillance. We examined factors that affect followup compliance and influence quality of care in these children. MATERIALS AND METHODS: We retrospectively reviewed the records of 288 boys and 742 girls with vesicoureteral reflux. RESULTS: Of the children treated nonsurgically for vesicoureteral reflux 34% were lost to followup and the majority (80%) were not monitored beyond the 1-year followup appointment. Older maternal age (36 years or older) was significantly associated with improved followup compliance. Paternal age, primary physician type, medical insurance type, income, education level and environment (urban, suburban or rural) were not significant. CONCLUSIONS: Approximately a third of children treated nonsurgically for vesicoureteral reflux will be lost to followup. Only older maternal age predicts for good compliance. Preconceptions about compliance on the basis of other factors, such as socioeconomic status and primary physician type, may be incorrect. Furthermore, the notion that certain forms of medical insurance plans may help to promote followup may also be unsupported. These children would benefit from efforts to improve compliance with a medical regimen or early correction of reflux.
PURPOSE: Nonsurgical treatment of vesicoureteral reflux requires antibiotic prophylaxis and long-term surveillance. We examined factors that affect followup compliance and influence quality of care in these children. MATERIALS AND METHODS: We retrospectively reviewed the records of 288 boys and 742 girls with vesicoureteral reflux. RESULTS: Of the children treated nonsurgically for vesicoureteral reflux 34% were lost to followup and the majority (80%) were not monitored beyond the 1-year followup appointment. Older maternal age (36 years or older) was significantly associated with improved followup compliance. Paternal age, primary physician type, medical insurance type, income, education level and environment (urban, suburban or rural) were not significant. CONCLUSIONS: Approximately a third of children treated nonsurgically for vesicoureteral reflux will be lost to followup. Only older maternal age predicts for good compliance. Preconceptions about compliance on the basis of other factors, such as socioeconomic status and primary physician type, may be incorrect. Furthermore, the notion that certain forms of medical insurance plans may help to promote followup may also be unsupported. These children would benefit from efforts to improve compliance with a medical regimen or early correction of reflux.
Authors: Ron Keren; Myra A Carpenter; Alejandro Hoberman; Nader Shaikh; Tej K Matoo; Russell W Chesney; Ranjiv Matthews; Arlene C Gerson; Saul P Greenfield; Barbara Fivush; Gordon A McLurie; H Gil Rushton; Douglas Canning; Caleb P Nelson; Lawrence Greenbaum; Timothy Bukowski; William Primack; Richard Sutherland; James Hosking; Dawn Stewart; Jack Elder; Marva Moxey-Mims; Leroy Nyberg Journal: Pediatrics Date: 2008-12 Impact factor: 7.124