Karolina Johansson1, Elin Malmberg Hård Af Segerstad1, Helena Mårtensson1, Daniel Agardh1,2.
Abstract
AIM: This study compared follow-up protocols for paediatric celiac disease (CD) led by either paediatricians or dietitians at Swedish university hospitals.
METHODS: We followed 363 CD patients under 18 years at the university hospitals in Malmö (n = 140) and Lund (n = 79) between 2011 and 2013 and after they merged to become Skåne (n = 144) between 2014 and 2016. Both Lund and Malmö provided regular paediatrician follow-up visits, whereas Skåne provided mainly dietitian-led visits.
RESULTS: Children at Lund were followed for a mean of 1.0 ± 0.5 visits per year, compared to 0.7 ± 0.6 at Malmö (p < 0.0001) and 0.9 ± 0.6 at Skåne (p = 0.11). The ratio of annual paediatrician to dietitian annual visits was 1.4:1.0 at Lund, which was higher than Malmö (0.9:1.0; p = 0.0017) and Skåne (0.6:1.0; p < 0.0001). There was no difference in the prevalence of non-compliant patients between the clinics (p = 0.26, Malmö 13.6%, Lund 10.1%, Skåne 7.6%). Tissue transglutaminase autoantibody levels reversed equally over time at all three clinics after the subjects started a gluten-free diet (r = -0.55, p < 0.0001). The total mean annual cost per patient was lowest at Malmö and highest at Lund (p < 0.0001).
CONCLUSION: Dietary compliance was similar regardless of whether care was provided by a dietitian or paediatrician. Dietitian-led follow-up visits may provide lower long-term costs. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
AIM: This study compared follow-up protocols for paediatric celiac disease (CD) led by either paediatricians or dietitians at Swedish university hospitals.
METHODS: We followed 363 CD patients under 18 years at the university hospitals in Malmö (n = 140) and Lund (n = 79) between 2011 and 2013 and after they merged to become Skåne (n = 144) between 2014 and 2016. Both Lund and Malmö provided regular paediatrician follow-up visits, whereas Skåne provided mainly dietitian-led visits.
RESULTS: Children at Lund were followed for a mean of 1.0 ± 0.5 visits per year, compared to 0.7 ± 0.6 at Malmö (p < 0.0001) and 0.9 ± 0.6 at Skåne (p = 0.11). The ratio of annual paediatrician to dietitian annual visits was 1.4:1.0 at Lund, which was higher than Malmö (0.9:1.0; p = 0.0017) and Skåne (0.6:1.0; p < 0.0001). There was no difference in the prevalence of non-compliant patients between the clinics (p = 0.26, Malmö 13.6%, Lund 10.1%, Skåne 7.6%). Tissue transglutaminase autoantibody levels reversed equally over time at all three clinics after the subjects started a gluten-free diet (r = -0.55, p < 0.0001). The total mean annual cost per patient was lowest at Malmö and highest at Lund (p < 0.0001).
CONCLUSION: Dietary compliance was similar regardless of whether care was provided by a dietitian or paediatrician. Dietitian-led follow-up visits may provide lower long-term costs. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Entities:
Keywords:
Celiac disease; Children; Compliance; Dietitian; Gluten-free diet
Mesh：
Year: 2018
PMID： 29782665 DOI： 10.1111/apa.14411
Source DB: PubMed Journal: Acta Paediatr ISSN： 0803-5253 Impact factor: 2.299