Is Dietitian Use Associated with Celiac Disease Outcomes?

Mahadev, SriHari; Simpson, Suzanne; Lebwohl, Benjamin; Lewis, Suzanne K.; Tennyson, Christina A.; Green, Peter H.R.

doi:10.3390/nu5051585

Cited by 41 publications

(44 citation statements)

References 24 publications

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“…Currently, the Celiac Dietary Assessment tool (CDAT) is the most widely used scoring system. The CDAT is a seven-item questionnaire that has been used and validated in six studies to date, involving 1855 patients (35,44,(46)(47)(48)(49) . The CDAT has yet to be compared to histology for adherence but was found to correlate highly with dietetic evaluations for assessing adherence (44) .…”

Section: Adherence Scoresmentioning

confidence: 99%

Long‐term care for patients with coeliac disease in the UK: a review of the literature and future directions

Kurien

Trott

Sanders

2016

J Human Nutrition Diet

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Coeliac disease is a common digestive disorder that affects 1% of adults. It is characterised by mucosal damage of the small intestine caused by dietary gluten. The main treatment for coeliac disease is a lifelong gluten‐free diet, which can reduce morbidity and mortality and also improve quality of life. Despite the benefits, adhering to this diet is often challenging, with patients often struggling to sustain dietary restriction. Structured follow‐up for coeliac disease is recommended in international guidelines for improving adherence and for detecting complications;however, uncertainty exists concerning exactly who should be administering this follow‐up care. Here, we undertake a review of the current approaches described in the literature to follow‐up patients with coeliac disease, and assess the efficacy of these differing models. We also explore future directions for the care of these patients in the context of the UK National Health Service (a publicly funded healthcare system). Although the focus of this review pertains to follow‐up within the UK healthcare system, these problems are recognised to be international, and so the findings of our review are likely to be of interest to all healthcare professionals seeing and managing patients with coeliac disease.

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Section: Adherence Scoresmentioning

confidence: 99%

Long‐term care for patients with coeliac disease in the UK: a review of the literature and future directions

Kurien

Trott

Sanders

2016

J Human Nutrition Diet

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“…In a study of biopsy-diagnosed CD patients, 40% of patients (n=164) agreed with the statement that it is difficult to find an RD knowledgeable about the GFD [12]. In a similar study which surveyed 160 biopsy-diagnosed CD patients, 54% of the participants (n=86) reported that RDNs did not seem to be knowledgeable about CD, and 53% of patients (n=85) did not find RDNs to be helpful [9].…”

Section: Discussionmentioning

confidence: 74%

Celiac Disease and the Gluten-free Diet: Registered Dietitian Nutritionists’ Self-reported Knowledge Varies

Geiger¹,

Rhee²,

Stastny³

et al. 2017

IJCD

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Background: Adherence to the gluten-free diet is the only treatment for celiac disease (CD) and some patients report lack of expertise among registered dietitian nutritionists (RDNs). Objective: To measure RDN self-reported celiac disease (CD) knowledge and preferences for resources for self-education and patient education. Methods: A cross-sectional research design was used to recruit RDNs from participating state affiliates Alaska, Colorado, Connecticut, Delaware, Montana, Nebraska, and North Dakota in 2013. A 35 item internet-based survey was distributed via Survey Monkey and included Likert scale questions based on a previous RDN allergy survey. Demographic and gluten-free diet and CD multiple-choice questions were also included. Results: Four-hundred and five registered dietitians (RDNs) who volunteered from the seven participating affiliates responded to the survey. Chi-squares were used to determine frequencies and differences in responses per variable. Pearson correlation analyses were performed to determine the correlation of age, education level, years of practice, or number of CD patients seen per week and CD self-reported knowledge. RDNs reported either moderate or high levels of knowledge for all seven self-reported knowledge topics. Over 85% of RDNs selected correct answers for five CD knowledge questions. Professional and academic publications were the most commonly used resources by RDNs for self-education whereas handouts were the most commonly used resource by RDNs for patient education. Conclusion: RDNs may need more reinforcement on identification and treatment of nutritional deficiencies of CD management.

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“…Most all participants perceived a reduction in symptoms, a finding by others. [13,42] Slow diagnosis prolongs suffering for many affected individuals in some cases for many years (43). The limitations of a GFD would indicate that follow-up of affected individuals is important and medical professionals were consulted by all but 3 participants.…”

Section: Perceived Benefits Of Gfdmentioning

confidence: 99%

Community Based Pilot Study of Diagnostic Paths to the Gluten Free Diet

Stevenson

Rankin-Sunter²,

Maki³

et al. 2016

IJCD

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Wheat consumption is increasing worldwide and also increasing is the frequency of celiac disease (CeD), a pathological response to wheat protein (gluten) in genetically susceptible individuals. Non-celiac gluten sensitivity (NCGS) is another, less studied wheat-induced pathology. The treatment for both is a gluten-free diet (GFD). More individuals choose the diet than predicted by the epidemiological 1-2% prevalence. A preliminary survey by questionnaire asked members and attendees of the local gluten information group (GIG) meetings and functions about their diagnostic experiences and symptom levels in order understand the increased demand for gluten-free foods. Same-aged and-sex friends participated as a comparative "control". Mixed methods were used including content analyses of prose narratives and independent and paired t tests of symptom levels measured with Likert scales. This convenience sample, surveyed in 2011-2012, is mostly female (54 F, 5 M) with an average age of 54.6 ± 2.0 years. Most participants consulted medical professionals with mean time to diagnosis of 7 years determined mostly from "classic" presenting symptoms. Negative biopsies or blood tests and atypical symptoms that overlap other conditions delayed diagnosis. There were 43 and 16 participants with CeD and NCGS, respectively differing little in symptom levels. Self-diagnosis and use of naturopaths account for some of the "excess" individuals. General practitioners should be encouraged to get additional nutrition training and to discuss with patients dietary choices that support wellness and minimize the risk for pathological immune responses. Patients with CeD particularly need support and follow-up in the transition to a GFD.

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Is Dietitian Use Associated with Celiac Disease Outcomes?

Cited by 41 publications

References 24 publications

Long‐term care for patients with coeliac disease in the UK: a review of the literature and future directions

Long‐term care for patients with coeliac disease in the UK: a review of the literature and future directions

Celiac Disease and the Gluten-free Diet: Registered Dietitian Nutritionists’ Self-reported Knowledge Varies

Community Based Pilot Study of Diagnostic Paths to the Gluten Free Diet

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