Valma Fuchs1, Kalle Kurppa1,2, Heini Huhtala3, Markku Mäki2, Leila Kekkonen4, Katri Kaukinen1,5. 1. Celiac Disease Research Center, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland. 2. Tampere Centre for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland. 3. Faculty of Social Sciences, University of Tampere, Tampere, Finland. 4. Finnish Coeliac Society, Tampere, Finland. 5. Department of Internal Medicine, Tampere University Hospital, Tampere, Finland.
Abstract
BACKGROUND: Celiac disease is challenging to recognize, predisposing to long diagnostic delay. Currently, associated factors and significance of the delay remain obscure. OBJECTIVE: The objective of this article is to investigate associated sociodemographic risk factors and health consequences of diagnostic delay in celiac disease. METHODS: Altogether 611 patients were surveyed at diagnosis and after one year on a gluten-free diet regarding sociodemographic variables, well-being and use of medicines and health care services. Quality of life was measured by a validated Psychological General Well-Being (PGWB) questionnaire. The results were compared between patients with and without delayed (≥3 years) diagnosis. RESULTS: A total of 332 (54%) individuals reported a delay of ≥3 years. Associated with the delay were being a student or homemaker, but not gender, marital or occupational status, site of diagnosis or place of residence. Patients with the delay also had decreased self-perceived health and poorer PGWB scores compared to those without delay; in anxiety and general health this was seen even on a gluten-free diet. Days of sickness and doctor visits as well as use of drugs for dyspepsia and antidepressants were increased in the delay group both before and after diagnosis. CONCLUSION: A delay in celiac disease diagnosis predisposes to reduced well-being and incremental use of medicines and health care services, both before diagnosis and one year after diagnosis.
BACKGROUND: Celiac disease is challenging to recognize, predisposing to long diagnostic delay. Currently, associated factors and significance of the delay remain obscure. OBJECTIVE: The objective of this article is to investigate associated sociodemographic risk factors and health consequences of diagnostic delay in celiac disease. METHODS: Altogether 611 patients were surveyed at diagnosis and after one year on a gluten-free diet regarding sociodemographic variables, well-being and use of medicines and health care services. Quality of life was measured by a validated Psychological General Well-Being (PGWB) questionnaire. The results were compared between patients with and without delayed (≥3 years) diagnosis. RESULTS: A total of 332 (54%) individuals reported a delay of ≥3 years. Associated with the delay were being a student or homemaker, but not gender, marital or occupational status, site of diagnosis or place of residence. Patients with the delay also had decreased self-perceived health and poorer PGWB scores compared to those without delay; in anxiety and general health this was seen even on a gluten-free diet. Days of sickness and doctor visits as well as use of drugs for dyspepsia and antidepressants were increased in the delay group both before and after diagnosis. CONCLUSION: A delay in celiac disease diagnosis predisposes to reduced well-being and incremental use of medicines and health care services, both before diagnosis and one year after diagnosis.
Entities:
Keywords:
Celiac disease; diagnostic delay; health care services; quality of life; sociodemographic
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