Dietitian visits were a safe and cost-effective form of follow-up care for children with celiac disease
(2019) In Acta Paediatrica, International Journal of Paediatrics 108(4). p.676-680- 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... (More)
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.
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- author
- Johansson, Karolina LU ; Malmberg Hård af Segerstad, Elin LU ; Mårtensson, Helena and Agardh, Daniel LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Celiac disease, Children, Compliance, Dietitian, Gluten-free diet
- in
- Acta Paediatrica, International Journal of Paediatrics
- volume
- 108
- issue
- 4
- pages
- 676 - 680
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:29782665
- scopus:85050608934
- ISSN
- 0803-5253
- DOI
- 10.1111/apa.14411
- language
- English
- LU publication?
- yes
- id
- c17e6572-e65d-4ffd-b349-c1165f3c1c16
- date added to LUP
- 2018-09-18 15:11:36
- date last changed
- 2024-08-05 22:34:37
@article{c17e6572-e65d-4ffd-b349-c1165f3c1c16, abstract = {{<p>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.</p>}}, author = {{Johansson, Karolina and Malmberg Hård af Segerstad, Elin and Mårtensson, Helena and Agardh, Daniel}}, issn = {{0803-5253}}, keywords = {{Celiac disease; Children; Compliance; Dietitian; Gluten-free diet}}, language = {{eng}}, number = {{4}}, pages = {{676--680}}, publisher = {{Wiley-Blackwell}}, series = {{Acta Paediatrica, International Journal of Paediatrics}}, title = {{Dietitian visits were a safe and cost-effective form of follow-up care for children with celiac disease}}, url = {{http://dx.doi.org/10.1111/apa.14411}}, doi = {{10.1111/apa.14411}}, volume = {{108}}, year = {{2019}}, }