Patients With Celiac Disease Are Not Followed Up Adequately

Margot L. Herman, Alberto Rubio-Tapia, Brian D. Lahr, Joseph J. Larson, Carol T. Van Dyke, Joseph A Murray

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background & Aims: Adherence to a gluten-free diet is the only effective treatment for celiac disease. It has been recommended that patients be followed up, make regular visits to the clinic, and undergo serologic analysis for markers of celiac disease, although a follow-up procedure has not been standardized. We determined how many patients with celiac disease are actually followed up. Methods: We collected data on 122 patients with biopsy-proven celiac disease, diagnosed between 1996 and 2006 in Olmsted County, Minnesota (70% women; median age, 42 y), for whom complete medical records and verification of residency were available. We determined the frequency at which patients received follow-up examinations, from 6 months to 5 years after diagnosis. The Kaplan-Meier method was used to estimate event rates at 1 and 5 years. Patients were classified according to categories of follow-up procedures recommended by the American Gastroenterological Association (AGA). Results: We estimated that by 1 and 5 years after diagnosis with celiac disease, 41.0% and 88.7% of the patients had follow-up visits, 33.6% and 79.8% were assessed for compliance with a gluten-free diet, 3.3% and 15.8% met with a registered dietitian, 2.5% and 18.1% had an additional intestinal biopsy, and 22.1% and 65.6% received serologic testing for markers of celiac disease, respectively. Among 113 patients (93%) who were followed up for more than 4 years, only 35% received follow-up analyses that were consistent with AGA recommendations. Conclusions: Patients with celiac disease are not followed up consistently. Follow-up examinations often are inadequate and do not follow AGA recommendations. Improving follow-up strategies for patients with celiac disease could improve management of this disease.

Original languageEnglish (US)
Pages (from-to)893-899
Number of pages7
JournalClinical Gastroenterology and Hepatology
Volume10
Issue number8
DOIs
StatePublished - Aug 2012

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Celiac Disease
Gluten-Free Diet
Biopsy
Nutritionists
Ambulatory Care
Internship and Residency
Disease Management
Medical Records

Keywords

  • Assessment
  • Food allergy
  • Long term
  • Therapy

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Patients With Celiac Disease Are Not Followed Up Adequately. / Herman, Margot L.; Rubio-Tapia, Alberto; Lahr, Brian D.; Larson, Joseph J.; Van Dyke, Carol T.; Murray, Joseph A.

In: Clinical Gastroenterology and Hepatology, Vol. 10, No. 8, 08.2012, p. 893-899.

Research output: Contribution to journalArticle

Herman, ML, Rubio-Tapia, A, Lahr, BD, Larson, JJ, Van Dyke, CT & Murray, JA 2012, 'Patients With Celiac Disease Are Not Followed Up Adequately', Clinical Gastroenterology and Hepatology, vol. 10, no. 8, pp. 893-899. https://doi.org/10.1016/j.cgh.2012.05.007
Herman, Margot L. ; Rubio-Tapia, Alberto ; Lahr, Brian D. ; Larson, Joseph J. ; Van Dyke, Carol T. ; Murray, Joseph A. / Patients With Celiac Disease Are Not Followed Up Adequately. In: Clinical Gastroenterology and Hepatology. 2012 ; Vol. 10, No. 8. pp. 893-899.
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AB - Background & Aims: Adherence to a gluten-free diet is the only effective treatment for celiac disease. It has been recommended that patients be followed up, make regular visits to the clinic, and undergo serologic analysis for markers of celiac disease, although a follow-up procedure has not been standardized. We determined how many patients with celiac disease are actually followed up. Methods: We collected data on 122 patients with biopsy-proven celiac disease, diagnosed between 1996 and 2006 in Olmsted County, Minnesota (70% women; median age, 42 y), for whom complete medical records and verification of residency were available. We determined the frequency at which patients received follow-up examinations, from 6 months to 5 years after diagnosis. The Kaplan-Meier method was used to estimate event rates at 1 and 5 years. Patients were classified according to categories of follow-up procedures recommended by the American Gastroenterological Association (AGA). Results: We estimated that by 1 and 5 years after diagnosis with celiac disease, 41.0% and 88.7% of the patients had follow-up visits, 33.6% and 79.8% were assessed for compliance with a gluten-free diet, 3.3% and 15.8% met with a registered dietitian, 2.5% and 18.1% had an additional intestinal biopsy, and 22.1% and 65.6% received serologic testing for markers of celiac disease, respectively. Among 113 patients (93%) who were followed up for more than 4 years, only 35% received follow-up analyses that were consistent with AGA recommendations. Conclusions: Patients with celiac disease are not followed up consistently. Follow-up examinations often are inadequate and do not follow AGA recommendations. Improving follow-up strategies for patients with celiac disease could improve management of this disease.

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