Determinants of Follow-up Care for Patients With Celiac Disease

Margot E. Cohen, Ariel Jaffe, Carolyn B. Strauch, Suzanne K. Lewis, Benjamin Lebwohl, Peter H.R. Green
2017 Journal of Clinical Gastroenterology  
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
more » ... o 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 Z2 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.
doi:10.1097/mcg.0000000000000851 pmid:28723859 fatcat:2t7keimb5fdebdatguiclflj3i