Determinants of Follow-up Care for Patients With Celiac Disease. Issue 9 (October 2018)

• Record Type: Journal Article
• Authors: Cohen, Margot E.; Jaffe, Ariel; Strauch, Carolyn B.; Lewis, Suzanne K.; Lebwohl, Benjamin; Green, Peter H.R.
• Is Part Of: Journal of clinical gastroenterology. Volume 52:Issue 9(2018)
• Publication Date: 2018-10
• Subjects: adherence -- gluten-sensitivity -- gender; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000000851
• Languages: English
• ISSNs: 0192-0790

Abstract

Abstract : Goals: This study aimed to investigate follow-up patterns among celiac disease (CD) patients. Background: Gender factors are important in CD with women diagnosed more frequently than men despite equal seropositivity in screening studies. To determine if gender influences postdiagnosis care, we performed a retrospective cohort study investigating the impact of gender and mode of presentation on follow-up patterns after diagnosis. Study: The study included adults with biopsy-proven CD presenting to a single tertiary care center between 2005 and 2014. The primary exposure was at least 1 visit with a CD specialist. The primary outcome was ≥2 follow-up visits, including office visits and endoscopic procedures. Data extracted included whether patients had tissue transglutaminase antibodies performed by our laboratory. Results: We analyzed 708 patients of which 70.5% were female. Follow-up was good with a majority of patients (69%) having at least 1 follow-up visit. On bivariate analysis, patients least likely to follow-up were ages 18 to 29 ( P =0.03) and women with atypical presentations ( P =0.003). After adjusting for potential confounders, individuals over age 65 were significantly more likely to attend at least 2 follow-up visits (odds ratio, 2.07; 95% confidence interval, 1.21-3.55; P =0.0079). Individuals with an abnormal baseline tissue transglutaminase antibody value in our laboratory were significantly more likely to follow-up (odds ratio, 1.99; 95% confidence interval, 1.39-2.85; P =0.0002). Conclusions: Gender had no impact on follow-up patterns despite prior studies demonstrating an impact on diagnosis rates. Future attention should focus on retaining young patients and those with atypical modes of presentation.