Use of health care services and pharmaceutical agents in coeliac disease: a prospective nationwide study

BMC Gastroenterology

Katri Kaukinen³  Markku Mäki¹  Leila Kekkonen⁴  Leena Forma²  Heini Huhtala²  Pekka Collin³  Kalle Kurppa¹  Anniina Ukkola¹ 

[1] Paediatric Research Centre, University of Tampere and Tampere University Hospital, Tampere, Finland;School of Health Sciences, University of Tampere, Tampere, Finland;Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland;Finnish Coeliac Society, Tampere, Finland

关键词: Sickness absence;    Health care service use;    Burden of illness;    Gluten-free diet;    Coeliac disease;   

Others  :  858371
DOI  :  10.1186/1471-230X-12-136

 received in 2012-03-22, accepted in 2012-09-21,  发布年份 2012

【 摘 要 】

Background

Approximately 1% of the population suffer from coeliac disease. However, the disease is heavily underdiagnosed. Unexplained symptoms may lead to incremented medical consultations and productivity losses. The aim here was to estimate the possible concealed burden of untreated coeliac disease and the effects of a gluten-free diet.

Methods

A nationwide cohort of 700 newly detected adult coeliac patients were prospectively evaluated. Health care service use and sickness absence from work during the year before diagnosis were compared with those in the general population; the data obtained from an earlier study. Additionally, the effect of one year on dietary treatment on the aforementioned parameters and on consumption of pharmaceutical agents was assessed.

Results

Untreated coeliac patients used primary health care services more frequently than the general population. On a gluten-free diet, visits to primary care decreased significantly from a mean 3.6 to 2.3. The consumption of medicines for dyspepsia (from 3.7 to 2.4 pills/month) and painkillers (6.8-5.5 pills/month) and the number of antibiotic courses (0.6-0.5 prescriptions/year) was reduced. There were no changes in hospitalizations, outpatient visits to secondary and tertiary care, use of other medical services, or sickness absence, but the consumption of nutritional supplements increased on treatment.

Conclusions

Coeliac disease was associated with excessive health care service use and consumption of drugs before diagnosis. Dietary treatment resulted in a diminished burden to the health care system and lower use of on-demand medicines and antibiotic treatment. The results support an augmented diagnostic approach to reduce underdiagnosis of coeliac disease.

Trial registration

ClinicalTrials.gov NCT01145287

【 授权许可】

   
2012 Ukkola et al.; licensee BioMed Central Ltd.

【 图 表 】

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