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

Johansson, Karolina LU ; Malmberg Hård af Segerstad, Elin LU ; Mårtensson, Helena and Agardh, Daniel LU (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
organization
publishing date
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 Publishing Ltd
external identifiers
  • 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
2019-09-17 04:38:44
@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 &lt; 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 &lt; 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 &lt; 0.0001). The total mean annual cost per patient was lowest at Malmö and highest at Lund (p &lt; 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},
  keyword      = {Celiac disease,Children,Compliance,Dietitian,Gluten-free diet},
  language     = {eng},
  number       = {4},
  pages        = {676--680},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  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},
  volume       = {108},
  year         = {2019},
}