Dietitian visits were a safe and cost-effective form of follow-up care for children with celiac disease

Acta Paediatrica
Karolina JohanssonDaniel Agardh

Abstract

This study compared follow-up protocols for paediatric celiac disease (CD) led by either paediatricians or dietitians at Swedish university hospitals. 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. 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). Dietary compliance was similar regardless of whether care was pro...Continue Reading

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Citations

Sep 18, 2018·PharmacoEconomics·Elizabeth S MearnsBenjamin Lebwohl
Jan 12, 2019·Nature Reviews. Disease Primers·Katri LindforsKatri Kaukinen
Jan 7, 2021·European Journal of Gastroenterology & Hepatology·Petra RiznikJernej Dolinsek

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