Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease.

Hall, Nicola, Rubin, Greg and Charnock, Anne (2009) Systematic review: adherence to a gluten-free diet in adult patients with coeliac disease. Alimentary Pharmacology and Theraputics, 30 (4). pp. 315-330.

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Coeliac disease is increasingly diagnosed in adult patients who present with atypical symptoms or who are asymptomatic and detected by case screening. Its treatment, a gluten-free diet, can have a considerable impact on daily living. Understanding the factors associated with non-adherence is important in terms of supporting patients with their condition.

To investigate factors associated with adherence to a gluten-free diet in adults with coeliac disease.

A literature search of multiple electronic databases using a pre-determined search string for literature between 1980 and November 2007 identified a possible 611 hits. After checking for relevance, 38 studies were included in this review.

Rates for strict adherence range from 42% to 91% depending on definition and method of assessment and are the lowest among ethnic minorities and those diagnosed in childhood. Adherence is most strongly associated with cognitive, emotional and socio-cultural influences, membership of an advocacy group and regular dietetic follow-up. Screen and symptom-detected coeliac patients do not differ in their adherence to a gluten-free diet.

The existing evidence for factors associated with non-adherence to a gluten-free diet is of variable quality. Further and more rigorous research is needed to characterize those individuals most likely to be non-adherent to assist them better with their treatment.

Item Type: Article
Divisions: Faculty of Health Sciences and Wellbeing
Depositing User: Wendy Tasker
Date Deposited: 04 Oct 2017 10:55
Last Modified: 04 Oct 2017 10:55

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