Insight in the diagnosis and treatment of coeliac disease in general practice: A survey and case vignette study among 106 general practitioners

Background Coeliac disease (CD) is a highly prevalent (∼1%) disease that allegedly remains undiagnosed in over 80% of the cases because of atypical symptoms or silent disease. Currently, it is unknown how GPs deal with (suspected) CD. Objectives This study aimed to better understand the diagnostic a...

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Autores principales:	Maxine D. Rouvroye, Pauline Slottje, Tom van Gils, Chris J. Mulder, Jean W. Muris, Dick Walstock, Marcel Reinders, Gerd Bouma
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	coeliac disease gluten diet general practice questionnaires and surveys Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/2c9623cfed104df48de490f91fc6c84b
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spelling	oai:doaj.org-article:2c9623cfed104df48de490f91fc6c84b2021-11-11T14:23:41ZInsight in the diagnosis and treatment of coeliac disease in general practice: A survey and case vignette study among 106 general practitioners1381-47881751-140210.1080/13814788.2021.1985455https://doaj.org/article/2c9623cfed104df48de490f91fc6c84b2021-01-01T00:00:00Zhttp://dx.doi.org/10.1080/13814788.2021.1985455https://doaj.org/toc/1381-4788https://doaj.org/toc/1751-1402Background Coeliac disease (CD) is a highly prevalent (∼1%) disease that allegedly remains undiagnosed in over 80% of the cases because of atypical symptoms or silent disease. Currently, it is unknown how GPs deal with (suspected) CD. Objectives This study aimed to better understand the diagnostic approach and the clinical reasoning process of GPs concerning CD and concurrently address diagnostic pitfalls. Methods A questionnaire with case vignettes to assess the knowledge, diagnostic reasoning pattern and practice for CD by GPs was developed. It was sent through academic GP research networks (encompassing over 1500 GPs) in two large cities and to smaller practices in rural areas. The questionnaire was composed of seven background questions, 13 questions related to four case vignettes and six additional CD-related questions Results Responses were received from 106 GPs. Knowledge on risk factors for CD and appropriate testing of at-risk populations was limited. Twenty-two percent would diagnose CD in adults exclusively based on serology, without histopathological confirmation. In total, 99% would refer a newly diagnosed patient to a dietitian to initiate a gluten-free diet (GFD). In the absence of symptoms, only 33% would initiate a GFD. Conclusion The results of this study have given us insight into the diagnostic process of GPs encountering patient with gluten-related complaints. Multiple serology test is available and used, while a positive serology test is not always followed up by a gastroduodenal biopsy to confirm the diagnosis. Most GPs would refer a symptomatic CD patient to a dietician for a GFD.Maxine D. RouvroyePauline SlottjeTom van GilsChris J. MulderJean W. MurisDick WalstockMarcel ReindersGerd BoumaTaylor & Francis Grouparticlecoeliac diseaseglutendietgeneral practicequestionnaires and surveysMedicine (General)R5-920ENEuropean Journal of General Practice, Vol 27, Iss 1, Pp 313-319 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	coeliac disease gluten diet general practice questionnaires and surveys Medicine (General) R5-920
spellingShingle	coeliac disease gluten diet general practice questionnaires and surveys Medicine (General) R5-920 Maxine D. Rouvroye Pauline Slottje Tom van Gils Chris J. Mulder Jean W. Muris Dick Walstock Marcel Reinders Gerd Bouma Insight in the diagnosis and treatment of coeliac disease in general practice: A survey and case vignette study among 106 general practitioners
description	Background Coeliac disease (CD) is a highly prevalent (∼1%) disease that allegedly remains undiagnosed in over 80% of the cases because of atypical symptoms or silent disease. Currently, it is unknown how GPs deal with (suspected) CD. Objectives This study aimed to better understand the diagnostic approach and the clinical reasoning process of GPs concerning CD and concurrently address diagnostic pitfalls. Methods A questionnaire with case vignettes to assess the knowledge, diagnostic reasoning pattern and practice for CD by GPs was developed. It was sent through academic GP research networks (encompassing over 1500 GPs) in two large cities and to smaller practices in rural areas. The questionnaire was composed of seven background questions, 13 questions related to four case vignettes and six additional CD-related questions Results Responses were received from 106 GPs. Knowledge on risk factors for CD and appropriate testing of at-risk populations was limited. Twenty-two percent would diagnose CD in adults exclusively based on serology, without histopathological confirmation. In total, 99% would refer a newly diagnosed patient to a dietitian to initiate a gluten-free diet (GFD). In the absence of symptoms, only 33% would initiate a GFD. Conclusion The results of this study have given us insight into the diagnostic process of GPs encountering patient with gluten-related complaints. Multiple serology test is available and used, while a positive serology test is not always followed up by a gastroduodenal biopsy to confirm the diagnosis. Most GPs would refer a symptomatic CD patient to a dietician for a GFD.
format	article
author	Maxine D. Rouvroye Pauline Slottje Tom van Gils Chris J. Mulder Jean W. Muris Dick Walstock Marcel Reinders Gerd Bouma
author_facet	Maxine D. Rouvroye Pauline Slottje Tom van Gils Chris J. Mulder Jean W. Muris Dick Walstock Marcel Reinders Gerd Bouma
author_sort	Maxine D. Rouvroye
title	Insight in the diagnosis and treatment of coeliac disease in general practice: A survey and case vignette study among 106 general practitioners
title_short	Insight in the diagnosis and treatment of coeliac disease in general practice: A survey and case vignette study among 106 general practitioners
title_full	Insight in the diagnosis and treatment of coeliac disease in general practice: A survey and case vignette study among 106 general practitioners
title_fullStr	Insight in the diagnosis and treatment of coeliac disease in general practice: A survey and case vignette study among 106 general practitioners
title_full_unstemmed	Insight in the diagnosis and treatment of coeliac disease in general practice: A survey and case vignette study among 106 general practitioners
title_sort	insight in the diagnosis and treatment of coeliac disease in general practice: a survey and case vignette study among 106 general practitioners
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/2c9623cfed104df48de490f91fc6c84b
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Insight in the diagnosis and treatment of coeliac disease in general practice: A survey and case vignette study among 106 general practitioners

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