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It is well known that significant noncompliance exists, and the situation in PKU would appear no different than other chronic conditions. In PKU, compliance is complex, being subject to diverse definitions, and factors influencing compliance include the nature and nurture of the patient, as well as the inconvenience, cost and availability of dietary treatment. It is also a dynamic process, with many patients changing between a state of compliance and partial and noncompliance. In PKU, compliance has received little rigorous study, and there have been few observational reports identifying barriers and behaviors impacting dietary compliance. Compliance assessment measures remain inadequately defined. The direct assessment of blood Phe concentration is perhaps the best overall measure, but there is no universal agreement about the number of Phe concentrations that should be within target range and frequency or timing of measurement. Although no one strategy for improving compliance is universally effective, and an individualized approach to noncompliance is essential, it is important to have clear evidence about the most effective strategies in achieving long\u2010term dietary adherence in PKU.<\/jats:p>","DOI":"10.1007\/s10545-010-9073-y","type":"journal-article","created":{"date-parts":[[2010,4,7]],"date-time":"2010-04-07T02:12:10Z","timestamp":1270606330000},"page":"665-670","source":"Crossref","is-referenced-by-count":162,"title":["The reality of dietary compliance in the management of phenylketonuria"],"prefix":"10.1002","volume":"33","author":[{"given":"Anita","family":"MacDonald","sequence":"first","affiliation":[{"name":"Birmingham Children's Hospital Steelhouse Lane Birmingham B4 6NH UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hulya","family":"Gokmen\u2010Ozel","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Nutrition and Dietetics Department Hacettepe University Ankara Samanpazar\u0131 06100 Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margreet","family":"van Rijn","sequence":"additional","affiliation":[{"name":"Section of Metabolic Diseases, Beatrix Children's Hospital University Medical Center Groningen, University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Burgard","sequence":"additional","affiliation":[{"name":"Center for Paediatric and Adolescent Medicine University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2010,4,7]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2004.tb00366.x"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-003-1197-8"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10545-005-4478-8"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.1994.tb13458.x"},{"key":"e_1_2_4_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00014245"},{"key":"e_1_2_4_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0149-2918(01)80109-0"},{"key":"e_1_2_4_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2007.00213.x"},{"key":"e_1_2_4_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10545-005-0014-0"},{"key":"e_1_2_4_10_1","first-page":"425","article-title":"Automated messaging to improve compliance with diabetes test monitoring","volume":"15","author":"Derose SF","year":"2009","journal-title":"Am J Manag Care"},{"key":"e_1_2_4_11_1","first-page":"42","article-title":"Persistence with drug therapy: a practical approach using administrative claims data","volume":"10","author":"Dezii CM","year":"2001","journal-title":"Manag Care"},{"key":"e_1_2_4_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2008.00879.x"},{"key":"e_1_2_4_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2009.00953.x"},{"key":"e_1_2_4_14_1","unstructured":"Gokmen OzelH KucukkasapT KoksalG et al (2008)Does maternal knowledge impact blood phenylalanine concentrations in Turkish children with phenylketonuria?J Inherit Metab DisJun 27; E\u2010pub ahead of print. doi:10.1007\/s10545\u2010008\u20100775\u20103."},{"key":"#cr-split#-e_1_2_4_15_1.1","unstructured":"Gokmen\u2010OzelH AhringK B\u00e9langer\u2010Quintana A et al (2009)Blood phenylalanine control in PKU: a survey of ten European centres. 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