Abstract
Background: Whether the diagnostic approach for celiac disease (CD) can really affect quality of life (QoL) and dietary compliance remains controversial.Aims: This study aimed to evaluate QoL and compliance to gluten-free diet (GFD) in adolescents/young adults diagnosed with CD through a screening strategy during childhood compared to age-matched CD patients diagnosed by case-finding and to assess whether follow-up at a referral center for CD influences compliance and QoL.Materials and Methods: Thirty-seven CD patients who were diagnosed by screening programs (SC-group) and 38 age-matched CD patients diagnosed due to symptoms (CF-group) were enrolled. Patients were asked to answer a questionnaire on QoL, dietary compliance, and follow-up care for CD.Results: Twenty-nine patients of the SC-group (median age 18.0 years, interquartile range [IQR] 16.0–19.0) and 31 patients of the CF-group (median age 17.0 years, IQR 15.5–18.0) completed the questionnaire. No significant difference relating adherence to the GFD and QoL was shown between the two groups. The majority (93.5%) of CF-group regularly had annual follow-up at a referral center compared to 37.9% of the SC-group (p < 0.001).Conclusion: The diagnostic strategy does not seem to impact QoL and dietary compliance. However, implementation of follow-up might still be necessary for patients identified through screening.
Highlights
The number of celiac disease (CD) patients has increased worldwide during the past few decades [1,2,3]
- CD patients (14–20 years old) diagnosed by screening programs carried out in primary schools of the Lazio region (Italy) in 2007 and 2010 [8, 9], which allowed to identification of altogether 45 new CD patients; and
A statistically significant difference between the two groups was found in relation to CD patient association membership: 24.1% of the SC-group was members of CD associations vs 54.8% of the CF-group (p = 0.039) (Figure 5)
Summary
The number of celiac disease (CD) patients has increased worldwide during the past few decades [1,2,3]. Diagnosis took up to 10 years or more, delaying treatment. An important proportion of children remains undiagnosed for more than 3 years, an unacceptable delay [5]. Imposing a permanent and sometimes demanding treatment such as the GFD in patients could impact quality of life (QoL) and dietary compliance. This could even be more crucial in adolescents, who are at risk of follow-up loss prior to and during transition to adult care [7]. Whether the diagnostic approach for celiac disease (CD) can really affect quality of life (QoL) and dietary compliance remains controversial
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