Comparing alternative follow-up strategies for patients with stable coeliac disease

Pritchard, Lucy; Waters, Carolyn; Murray, Iain A.; Bebb, James R.; Lewis, Stephen J.

doi:10.1136/flgastro-2018-101156

Cited by 11 publications

(14 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Croker et al 29 explored patient preferences for CD annual reviews; however, the delivery structure was not part of their study. Pritchard et al 30 reported CD follow-up provision by face-to-face appointment with a general practitioner (GP) compared with a nurse-led telephone clinic. Of the adults who were offered a telephone clinic, they were more likely to receive an annual review, have their symptoms assessed and their diet reviewed compared with those who had GP follow-up provision.…”

Section: Discussionmentioning

confidence: 99%

Telephone clinic improves gluten-free dietary adherence in adults with coeliac disease: sustained at 6 months

Muhammad

Reeves

Ishaq

et al. 2020

Frontline Gastroenterol

View full text Add to dashboard Cite

BackgroundA gluten-free (GF) diet is the only treatment for coeliac disease (CD), non-adherence to the diet is associated with greater morbidity. The study aimed to examine the effect of a telephone clinic, designed to increase GF dietary knowledge and adherence, in adults with CD.MethodsA prospective study of 125 patients with histologically confirmed CD. Patients, not adhering to a GF diet (n=30), engaged in a personalised telephone clinic. Validated questionnaires were used to assess GF dietary adherence (Coeliac Disease Adherence Test; CDAT), knowledge of GF foods and CD-related quality of life (QoL). GF dietary adherence was assessed up to 12 months post telephone clinic. The control group completed the questionnaires only.ResultsGF dietary adherence (CDAT) median scores significantly improved at 3 and 6 months after the telephone clinic compared with baseline (16, 13 and 13, respectively, p<0.01). Reassuringly, the dietary burden QoL score remained similar to baseline values. No change in CDAT scores were observed in the control group. Change in GF dietary knowledge score was associated with improved GF dietary adherence CDAT score (r=−0.22; p=0.039). At 9 and 12 months, CDAT scores were similar to baseline values.ConclusionsTelephone clinics have a positive impact on dietary knowledge and GF dietary adherence in adults with CD, promoting health-benefitting behaviours in those previously not adhering to a GF diet. The study highlights the need for patients to have regular follow-up, with targeted reviews for those not adhering to a GF diet.

show abstract

Section: Discussionmentioning

confidence: 99%

Telephone clinic improves gluten-free dietary adherence in adults with coeliac disease: sustained at 6 months

Muhammad

Reeves

Ishaq

et al. 2020

Frontline Gastroenterol

View full text Add to dashboard Cite

show abstract

“…After correction of these disturbances, initiation of supplements for nutritional deficiencies and rigorous counseling, these patients are usually sufficiently stable to be discharged home. Strict adherence to a gluten-free diet and regular follow up with a care provider may prevent future hospitalizations and the development of complications [ 16 ]. In our study, from 2007-2017, a majority (68.17%) of the CeD hospitalizations were deemed stable enough to be discharged home; however, we noted a trend towards decreasing home discharges and an increasing trend for transfers to other facilities, such as skilled nursing facilities and intermediate care facilities, and discharge home with home healthcare.…”

Section: Discussionmentioning

confidence: 99%

Celiac disease hospitalizations: an emerging challenge in the United States

Dahiya

Al‐Haddad

Perisetti

et al. 2022

aog

View full text Add to dashboard Cite

Background This study aimed to assess the trends and characteristics of celiac disease (CeD) hospitalizations in the United States (US). Methods The National Inpatient Sample was analyzed from 2007-2017 to identify all adult hospitalizations with a primary discharge diagnosis of CeD. Demographic trends, associations, and other aspects of CeD hospitalizations were analyzed. SAS 9.4 was used for statistical analysis and P-values ≤0.05 were considered statistically significant. Results From 2007-2017, we noted an increasing trend of CeD hospitalizations from 19,385 in 2007 to 38,395 in 2017 (P-trend <0.001). The mean age was 57.85 years, with a declining trend. Females and patients with a Charlson Comorbidity Index score ≥3 had a rising trend of CeD hospitalizations from 70.68% in 2007 to 73% in 2017 (P-trend <0.001) and from 16.96% in 2007 to 26.59% in 2017 (P-trend <0.001), respectively. Additionally, a White predominance was seen in the study cohort. Furthermore, for CeD hospitalizations, all-cause inpatient mortality increased from 1.30% in 2007 to 1.58% in 2017 (P-trend <0.001) and the mean total hospital charge increased from $26,299 in 2007 to $49,282 in 2017 (P-trend <0.001). However, we noted a decline in the mean length of stay (LOS) from 4.88 days in 2007 to 4.59 days in 2017 (P-trend=0.0015) and rates of esophagogastroduodenoscopy performed from 2.09% in 2007 to 1.89% in 2017 (P-trend <0.001). Conclusion We noted a rising trend in hospitalizations, inpatient mortality, and hospital costs for CeD hospitalizations in the US; however, inpatient EGDs performed and mean LOS showed a decline.

show abstract

“…A recent study by Pritchard et al suggests that over 75% of CD patients have no primary care follow-up appointment, 33 despite the fact that telephone follow-up clinics have been shown to have a positive impact of GFD adherence in adults with CD. 34 This combined with the finding that 36.0% of gastroenterologists felt that doctors were not required for the management of CD and that 30% of all CD patients have non-responsive CD (defined as persisting symptoms despite being on a GFD), 35 suggests the need for an achievable, standardised national follow-up service for CD.…”

Section: Discussionmentioning

confidence: 99%

Do gastroenterologists have medical inertia towards coeliac disease? A UK multicentre secondary care study

Taylor

Blanshard

Naylor

et al. 2021

BMJ Open Gastroenterol

View full text Add to dashboard Cite

ObjectiveThis study aimed to assess if there is secondary care medical inertia towards coeliac disease (CD).DesignGroup (1): Time from primary care presentation to diagnostic endoscopy was quantified in 151 adult patients with a positive endomysial antibody test and compared with 92 adult patients with histologically proven inflammatory bowel disease (IBD). Group (2): Across four hospitals, duodenal biopsy reports for suspected CD were reviewed (n=1423). Group (3): Clinical complexity was compared between known CD (n=102) and IBD (n=99) patients at their respective follow-up clinic appointments. Group (4): 50 gastroenterologists were questioned about their perspective on CD and IBD.ResultsGroup (1): Suspected coeliac patients waited significantly longer for diagnostic endoscopy following referral (48.5 (28–89) days) than suspected patients with IBD (34.5 (18–70) days; p=0.003). Group (2): 1423 patients underwent diagnostic endoscopy for possible CD, with only 40.0% meeting guidelines to take four biopsies. Increased diagnosis of CD occurred if guidelines were followed (10.1% vs 4.6% p<0.0001). 12.4% of newly diagnosed CD patients had at least one non-diagnostic gastroscopy in the 5 years prior to diagnosis. Group (4): 32.0% of gastroenterologists failed to identify that CD has greater prevalence in adults than IBD. Moreover, 36.0% of gastroenterologists felt that doctors were not required for the management of CD.ConclusionProlonged waiting times for endoscopy and inadequacies in biopsy technique were demonstrated suggesting medical inertia towards CD. However, this has to be balanced against rationalising care accordingly. A Coeliac UK National Patient Charter may standardise care across the UK.

show abstract

Comparing alternative follow-up strategies for patients with stable coeliac disease

Cited by 11 publications

References 14 publications

Telephone clinic improves gluten-free dietary adherence in adults with coeliac disease: sustained at 6 months

Telephone clinic improves gluten-free dietary adherence in adults with coeliac disease: sustained at 6 months

Celiac disease hospitalizations: an emerging challenge in the United States

Do gastroenterologists have medical inertia towards coeliac disease? A UK multicentre secondary care study

Contact Info

Product

Resources

About