Risk of Drop-Out from Follow-Up Evaluations for Celiac Disease: Is It Similar for All Patients?

Francesco Tovoli,Alberto Raiteri,Vito Sansone,Teresa Catenaro,Alice Giamperoli,Chiara Faggiano,Alessandro Granito,Dante Pio Pallotta

doi:10.3390/nu14061223

Francesco Tovoli, Alberto Raiteri + Show 6 more

Open Access

https://doi.org/10.3390/nu14061223

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Journal: Nutrients	Publication Date: Mar 14, 2022
Citations: 1	License type: CC BY 4.0

Affiliation: University of Bologna, Policlinico S.Orsola-Malpighi

Abstract

Background: Celiac disease (CD) follow-up is a relatively underevaluated topic. However, correct adherence to follow-up procedures is central to the early recognition of complicated CD and other conditions typically associated with CD. Establishing whether patients at increased risk of complications follow clinicians’ recommendations has multiple repercussions. Methods: We retrospectively analyzed the records of patients consecutively diagnosed with CD in our outpatient clinic between January 2004 and October 2017 to investigate the factors associated with drop-out from follow-up procedures. Results: Among the 578 patients analyzed, 40 (6.9%) dropped out during the first six months and 272 (50.6%) during the observation period. The median time to drop-out was 7.4 years (95% confidence interval: 6.8–8.0). No factors were associated with early drop-out. Instead, age at diagnosis >40 years (40–59 years, p < 0.001; ≥60 years, p = 0.048) and classical clinical presentation (p = 0.016) were significantly associated with a lower risk of later drop-out. Conclusions: Patients at increased risk of complicated CD are more compliant with follow-up procedures than patients at lower risk, despite being prescribed the same controls. These results indirectly support the hypothesis of tailored follow-up strategies, differentiated according to the risk of complications.

Highlights

Accepted: 10 March 2022Celiac disease (CD) is a chronic condition affecting about 1% of the general population [1]
As a consequence of these possible difficulties, all guidelines for CD provide physicians and other healthcare professionals with follow-up recommendations for CD patients [11–15]. These follow-up programs are not merely limited to verifying gluten-free diet (GFD) adherence. They encompass a wide range of objectives, such as investigating the possible persistence of gluten-related symptoms, development of concurrent autoimmune diseases, and early detection of complicated CD [16]
We aimed to identify the factors that can influence and affect the short and long-term adherence of patients to follow-up evaluations prescribed by their physicians according to the current guidelines

Summary

Introduction

Accepted: 10 March 2022Celiac disease (CD) is a chronic condition affecting about 1% of the general population [1]. Metabolic syndrome and hepatic steatosis may appear in a significant proportion of patients as early as two years after beginning a GFD [7–10]. As a consequence of these possible difficulties, all guidelines for CD provide physicians and other healthcare professionals with follow-up recommendations for CD patients [11–15]. These follow-up programs are not merely limited to verifying GFD adherence. Instead, they encompass a wide range of objectives, such as investigating the possible persistence of gluten-related symptoms, development of concurrent autoimmune diseases, and early detection of complicated CD [16]

Objectives

Methods

Conclusion