Patient perceptions of the Finnish guidelines enabling coeliac disease diagnosis without biopsies in adults.

Autor:	Sareila H; Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.; Hatanpää Health Care Centre, Wellbeing Services County of Pirkanmaa, Tampere, Finland., Kurppa K; Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.; Tampere Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland.; Department of Paediatrics, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland.; The University Consortium of Seinäjoki, Seinäjoki, Finland., Huhtala H; Faculty of Social Sciences, Tampere University, Tampere, Finland., Laurikka P; Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.; Department of Internal Medicine, Kanta-Häme Central Hospital, Wellbeing Services County of Hanta-Häme, Hämeenlinna, Finland., Arnala S; Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland., Koskela T; Department of General Practice, Faculty of Medicine and Health Technology, University of Tampere, Finland.; Wellbeing Services County of Pirkanmaa, Tampere, Finland., Kaukinen K; Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.; Department of Internal Medicine, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland., Kivelä L; Celiac Disease Research Centre, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.; Department of Paediatrics, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland.; Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
Jazyk:	angličtina
Zdroj:	Scandinavian journal of gastroenterology [Scand J Gastroenterol] 2024 Dec 02, pp. 1-8. Date of Electronic Publication: 2024 Dec 02.
DOI:	10.1080/00365521.2024.2431628
Abstrakt:	Objectives: Diagnosis of coeliac disease based on serology only has been allowed since 2018 in Finland for adults meeting specific criteria. We studied the patient experiences and perceptions of this novel diagnostic option. Methods: Altogether 194 adult patients were questioned on socio-demographic and health-related characteristics, quality of life and various coeliac disease-related issues. The results were compared between patients diagnosed with intestinal biopsy or based on serology only. Results: Altogether 69 (36%) of the patients were diagnosed without duodenal biopsies. They were younger (median 43 vs. 51 years, p  = 0.046), diagnosed more recently (2021 vs. 2020, p  < 0.001) and more often in primary health care (78% vs. 43%, p  = 0.001), had fewer esophageal symptoms at diagnosis (17% vs. 30%, p  = 0.046) and considered the diagnostic process easier (49% vs. 30%, p  = 0.032) than those diagnosed by duodenal biopsy ( n  = 125). The no-biopsy group received less often dietician follow-up (4% vs. 17%, p  = 0.012), reported more persistent symptoms (36% vs. 21%, p  = 0.026) and experienced more stress due to the diet (68% vs. 47%, p  = 0.039). Symptom persistence or stress were not associated with year of diagnosis or dietician follow-up. The groups were comparable in socio-economic characteristics, general health, quality of life, diagnostic delay, dietician guidance at diagnosis, and dietary adherence. Conclusions: The non-invasive approach resulted in de-centralized diagnosis and easier patient-experienced diagnostic process of coeliac disease, but was associated with increased risk for persistent symptoms and stress due to gluten-free diet. These results highlight the significance of appropriate patient guidance and support regardless of the diagnostic strategy.
Databáze:	MEDLINE
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