Referral for Dietary Intervention in Celiac Disease Is Low among Gastroenterologists and Primary Care Providers

Background: Strict adherence to a gluten-free diet is the only known effective treatment for celiac disease currently. Multiple organizations recommend follow-up with a dietitian and guideline-directed management after diagnosis. Few studies have evaluated follow-up post diagnosis. However, these do not include a systematic process for monitoring dietary referral among celiac disease patients. We sought to evaluate and compare the frequency of early dietary referral and guideline-directed preventive care and management for celiac disease patients managed by gastroenterologists and primary care providers.

Methods: A retrospective chart review of celiac disease patients receiving care at a single tertiary care facility. Our primary outcome was to compare the frequency of dietary intervention between gastroenterologists and primary care providers in an outpatient setting after initial diagnosis. Multivariate analysis was performed to determine associated factors for referral for dietary intervention and recommended follow-up lab work.

Results: 261 patients were included in the study, 81.6% were followed by gastroenterologist and only 51% were seen by a dietitian. Patients following up with gastroenterologists had higher odds of referral for dietary intervention on multivariate analysis (OR 3.29, p value <0.003). Only 16% of all patients completed appropriate guideline-directed follow-up care.

Conclusions: Dietary intervention and follow-up of preventive care lab work were low in celiac disease patients. There is an opportunity for further education of both primary care providers and gastroenterologists on the importance of early dietary referral and appropriate medical management at follow-up.

This is the accepted manuscript version of an article published by S. Karger AG in [Referral for Dietary Intervention in Celiac Disease Is Low among Gastroenterologists and Primary Care Providers. Digestive Diseases 41, 2 p343-352 (2022)] and available on www.karger.com/Article/FullText/10.1159/000525398

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Work Title Referral for Dietary Intervention in Celiac Disease Is Low among Gastroenterologists and Primary Care Providers
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Open Access
Creators
  1. Niranjani Venkateswaran
  2. Benjamin Claxton
  3. David Locke
  4. Allison Baragona
  5. Erik B. Lehman
  6. Shannon Dalessio
  7. Kofi Clarke
Keyword
  1. Celiac disease
  2. Quality improvement
  3. Dietary intervention
  4. Nutrition
  5. Preventive care
License In Copyright (Rights Reserved)
Work Type Article
Publisher
  1. Digestive Diseases
Publication Date June 15, 2022
Publisher Identifier (DOI)
  1. https://doi.org/10.1159/000525398
Deposited March 06, 2024

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  • Created
  • Added manuscript_3_13-2022-05-16-14-18-02.Submitted.docx
  • Added table1_3_11-2022-05-10-14-44-41.Submitted.docx
  • Added table2_3_10-2022-05-10-14-44-24.Submitted.docx
  • Added table3_3_9-2022-05-10-14-44-08.Submitted.docx
  • Added Fig1_3_7-2022-03-07-13-21-57.Submitted.tif
  • Added Fig2_3_8-2022-03-07-13-24-28.Submitted.tif
  • Added Creator Niranjani Venkateswaran
  • Added Creator Benjamin Claxton
  • Added Creator David Locke
  • Added Creator Allison Baragona
  • Added Creator Erik B. Lehman
  • Added Creator Shannon Dalessio
  • Added Creator Kofi Clarke
  • Published
  • Updated Keyword, Description, Publication Date Show Changes
    Keyword
    • Celiac disease, Quality improvement, Dietary intervention, Nutrition, Preventive care
    Description
    • <p>Background: Strict adherence to a gluten-free diet is the only known effective treatment for celiac disease currently. Multiple organizations recommend follow-up with a dietitian and guideline-directed management after diagnosis. Few studies have evaluated follow-up post diagnosis. However, these do not include a systematic process for monitoring dietary referral among celiac disease patients. We sought to evaluate and compare the frequency of early dietary referral and guideline-directed preventive care and management for celiac disease patients managed by gastroenterologists and primary care providers. Methods: A retrospective chart review of celiac disease patients receiving care at a single tertiary care facility. Our primary outcome was to compare the frequency of dietary intervention between gastroenterologists and primary care providers in an outpatient setting after initial diagnosis. Multivariate analysis was performed to determine associated factors for referral for dietary intervention and recommended follow-up lab work. Results: 261 patients were included in the study, 81.6% were followed by gastroenterologist and only 51% were seen by a dietitian. Patients following up with gastroenterologists had higher odds of referral for dietary intervention on multivariate analysis (OR 3.29, p value &lt;0.003). Only 16% of all patients completed appropriate guideline-directed follow-up care. Conclusions: Dietary intervention and follow-up of preventive care lab work were low in celiac disease patients. There is an opportunity for further education of both primary care providers and gastroenterologists on the importance of early dietary referral and appropriate medical management at follow-up.</p>
    • <p>Background: Strict adherence to a gluten-free diet is the only known effective treatment for celiac disease currently. Multiple organizations recommend follow-up with a dietitian and guideline-directed management after diagnosis. Few studies have evaluated follow-up post diagnosis. However, these do not include a systematic process for monitoring dietary referral among celiac disease patients. We sought to evaluate and compare the frequency of early dietary referral and guideline-directed preventive care and management for celiac disease patients managed by gastroenterologists and primary care providers.
    • Methods: A retrospective chart review of celiac disease patients receiving care at a single tertiary care facility. Our primary outcome was to compare the frequency of dietary intervention between gastroenterologists and primary care providers in an outpatient setting after initial diagnosis. Multivariate analysis was performed to determine associated factors for referral for dietary intervention and recommended follow-up lab work.
    • Results: 261 patients were included in the study, 81.6% were followed by gastroenterologist and only 51% were seen by a dietitian. Patients following up with gastroenterologists had higher odds of referral for dietary intervention on multivariate analysis (OR 3.29, p value &lt;0.003). Only 16% of all patients completed appropriate guideline-directed follow-up care.
    • Conclusions: Dietary intervention and follow-up of preventive care lab work were low in celiac disease patients. There is an opportunity for further education of both primary care providers and gastroenterologists on the importance of early dietary referral and appropriate medical management at follow-up.</p>
    Publication Date
    • 2023-03-01
    • 2022-06-15
  • Updated