National survey on the experiences of people with celiac disease in Spain. The CELIAC-SPAIN project

Enhancing life with celiac disease: unveiling effective tools for assessing health-related quality of life

Celiac disease (CD) is an autoimmune chronic enteropathy provoked by gluten ingestion in genetically predisposed individuals. Considering it´s only safe treatment is a lifelong gluten-free diet, the burden of living with the disease becomes evident, as well as the need to assess CD health-related quality of life (HRQOL). This review aims to identify and analyze the instruments used to evaluate the HRQOL of adults with CD. This integrative review using a systematic approach was designed to achieve high scientific standards. Accordingly, the search strategy was developed and executed as recommended by the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Detailed individual searches were developed to Pubmed, Science Direct, Scopus, Web of Science, and Google Scholar. After careful analysis of the papers, 43 studies were included, in which seven instruments were identified: Celiac Disease Questionnaire (CDQ) (n=21), Celiac Disease Specific Quality of Life Instrument (CD-QOL) (n=17), Celiac Disease Assessment Questionnaire (CDAQ) (n=4), CeliacQ-7 (n=1), CeliacQ-27 (n=1), Black and Orfila´s self-developed instrument (n=1) and the Coeliac Disease Quality of Life Questionnaire (CDQL) (n=1). The CDQ and CD-QOL were the two most applied instruments. Since the first focuses on the physical and mental symptoms related to the disease and the second focuses on the emotional repercussions of adhering to the GFD treatment for life (dysphoria), the CDQ application is an interesting option for countries that struggle with public policies for CD patients and patients with active CD. The CD-QOL could be used for countries with strict regulations for CD and gluten-free products and populations in remission. When comparing results among different populations, it is preferable to utilize culturally validated instruments, which have been applied across multiple countries, providing greater comparability between study findings.

Celiac patient satisfaction with nursing consultations in a gastroenterology department

The assessment of the personal care received is an indicator of the quality of the health care system. The diagnosis of celiac disease generates concern in the patient and limits the quality of life, and adherence to treatment determines symptomatic improvement. For this reason, a nursing consultation for health and nutritional education for celiac patients has been set up in our hospital. The objectives were to know the degree of patient´s satisfaction of this health program regarding technical and communicative aspects, as well as to assess the influence of adherence to the gluten-free diet (GFD) on health through clinical and analytical parameters. This is a descriptive cross-sectional observational study in patients diagnosed of celiac disease from January 2019 to June 2021 according to the Catassi criteria and who have attended the nursing consultation. Subsequently, the satisfaction survey was carried out and the clinical and analytical results were analyzed descriptively and statistically using the Student's t-test. The satisfaction of the nursing consultation was higher than 90%, highlighting aspects such as the clarity of the information, the interest and the kindness of the healthcare professionals. About 94.5% of the patients showed clinical improvement after the health education and the levels of hemoglobin, ferritin and vitamin B12 increased significantly in the analytical control after the GFD.

Review article: Dietary management of coeliac disease

As the gluten-free diet is currently the only treatment for coeliac disease and one that needs to applied in the long term, this review aims to explore the various issues confronting an individual and discuss the importance of ongoing dietary management. The process of dietary counselling has shifted from one that focuses on just foods to avoid to one that evaluates the multiple life factors (social, cultural, environmental, biological) that affect the individual's food choices and dietary behaviour. The nutritional quality of a gluten-free diet continues to affect vitamin, mineral and weight status of individuals with coeliac disease. There are many barriers to dietary adherence including increased cost and limited availability of gluten-free products, as well as the negative impact on an individual's social domain of quality of life. Therefore, assessment, education and counselling by a coeliac specialist dietitian should be the cornerstone of dietary management.