Factors governing long‐term adherence to a gluten‐free diet in adult patients with coeliac disease. Issue 6 (23rd July 2015)

• Record Type: Journal Article
• Authors: Villafuerte‐Galvez, J.; Vanga, R. R.; Dennis, M.; Hansen, J.; Leffler, D. A.; Kelly, C. P.; Mukherjee, R.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 42:Issue 6(2015)
• Page Start: 753
• Page End: 760
• Publication Date: 2015-07-23
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.13319
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt13319-abs-0001"> <title>Summary</title> <sec id="apt13319-sec-0001" sec-type="section"> <title>Background</title> <p>A strict gluten‐free diet is the cornerstone of treatment for coeliac disease. Studies of gluten‐free diet adherence have rarely used validated instruments. There is a paucity of data on long‐term adherence to the gluten‐free diet in the adult population.</p> </sec> <sec id="apt13319-sec-0002" sec-type="section"> <title>Aims</title> <p>To determine the long‐term adherence to the gluten‐free diet and potential associated factors in a large coeliac disease referral centre population.</p> </sec> <sec id="apt13319-sec-0003" sec-type="section"> <title>Methods</title> <p>We performed a mailed survey of adults with clinically, serologically and histologically confirmed coeliac disease diagnosed ≥5 years prior to survey. The previously validated Celiac Disease Adherence Test was used to determine adherence. Demographic, socio‐economic and potentially associated factors were analysed with adherence as the outcome.</p> </sec> <sec id="apt13319-sec-0004" sec-type="section"> <title>Results</title> <p>The response rate was 50.1% of 709 surveyed, the mean time on a gluten‐free diet 9.9 ± 6.4 years. Adequate adherence (celiac disease adherence test score <13) was found in 75.5% of respondents. A higher level of education was associated with adequate adherence (<italic>P</italic> = 0.002) even after controlling for household income (<italic>P</italic> = 0.0220). Perceptions of cost, effectiveness of the gluten‐free diet, knowledge of the gluten‐free diet and self‐effectiveness at following the gluten‐free diet correlated with adherence scores (<italic>P</italic> < 0.001).</p> </sec> <sec id="apt13319-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Long‐term adherence to a gluten‐free diet was adequate in >75% of respondents. Perceived cost remains a barrier to adherence. Perceptions of effectiveness of gluten‐free diet as well as its knowledge, are potential areas for intervention.</p> </sec> </abstract>