Nutritional and Gastroenterological Monitoring of Patients With Celiac Disease During COVID-19 Pandemic: The Emerging Role of Telemedicine and Point-of-Care Gluten Detection Tests

Published on Apr 13, 2021in Frontiers in Nutrition3.365
· DOI :10.3389/FNUT.2021.622514
Andrea Costantino4
Estimated H-index: 4
Leda Roncoroni16
Estimated H-index: 16
+ 6 AuthorsLuca Elli23
Estimated H-index: 23
Background and Aims: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, telemedicine has been supporting many patients with chronic diseases worldwide. However, data on celiac disease (CeD) nutritional and gastroenterological remote monitoring are scanty. The aims of our study were to verify patients' trust in telemedicine and to evaluate the feasibility of telemedicine in nutritional monitoring. Material and Methods: We used telemedicine in place of the scheduled but not provided follow-up visits during the first lockdown of the COVID-19 pandemic. Patients received a phone call, and televisits were conducted for CeD patients with mild or moderate symptoms and/or with blood alterations. The patient's adherence to the gluten-free diet (GFD) was evaluated according to the Celiac Dietary Adherence Test (CDAT). When gluten contamination was suspected, a point-of-care gluten detection test was prescribed. The patient's trust in telemedicine was assessed, through an adapted version of the Patient Trust Assessment Tool (PATAT) questionnaire, as the percentage of patients giving a score of at least 4 out of 5 on a Likert scale for three selected key statements: "I can trust televisit," "I can trust that possible problems with the telemedicine service will be solved properly," and "I feel at ease when working with this website." Results: One hundred and twelve CeD patients were phone called; among symptomatic patients, 39 out of the 42 scheduled (92.9%) televisits were performed. Among the 39 visits, 34 (87.2%) questionnaires were compiled. The patients included in the study obtained a CDAT score from 7 to 13 (11 ± 2). Gluten detection tests were prescribed to 11 patients, resulting positive in 2. Trust in the telemedicine service was achieved in 94.1, 88.2, and 97.1% for the three selected key statements of the PATAT questionnaire. Conclusion: During the COVID-19 pandemic, telemedicine showed to be feasible and the majority of patients trusted the combined gastroenterological and nutritional televisits. Gluten detection tests demonstrated to be useful tools for the patient and for the caregiver to confirm adherence to the GFD remotely.
7 CitationsSource
#1Luca Elli (University of Milan)H-Index: 23
#2Donatella Barisani (University of Milano-Bicocca)H-Index: 26
Last. Leda Roncoroni (University of Milan)H-Index: 16
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The outbreak of COVID-19 and SARS-CoV-2 infection is spreading worldwide as the first coronavirus pandemic. The clinical picture is variable but flu-like symptoms are common with bilateral interstitial pneumonia being the most frightening presentation. No specific therapies nor vaccine have been developed to date and the only way to limit the virus diffusion is by modifying one's lifestyle limiting social life and following strict hygienic precautions. No data is available on the risk of COVID-1...
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#1Luca Elli (University of Milan)H-Index: 23
#2Lucia Scaramella (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 3
Last. Maurizio Vecchi (University of Milan)H-Index: 54
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Clinics and Research in Hepatology and Gastroenterology - Sous presse. Epreuves corrigees par l'auteur. Disponible en ligne depuis le vendredi 4 septembre 2020
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#1Monica Siniscalchi (UNISA: University of Salerno)H-Index: 11
#2Fabiana Zingone (UNIPD: University of Padua)H-Index: 22
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Abstract Background Coronavirus Disease 2019 (COVID-19) causes severe complications and deaths all over the world. COVID-19 also has indirect effects from the lockdown and the possible lack of food. We aimed to evaluate the perception of this in Celiac Disease (CeD) patients who require a lifelong gluten-free diet as a therapy. Methods We invited by e-mail CeD adult patients from the University of Salerno (Campania, South Italy) and the University of Padua (Veneto, North Italy) to answer an ad h...
32 CitationsSource
#1Luca Elli (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 23
#2Karla A. Bascuñán (University of Chile)H-Index: 8
Last. Leda Roncoroni (University of Milan)H-Index: 14
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BACKGROUND: Gluten-free diet (GFD) decreases the quality of life of celiac disease (CD) patients, who frequently ask to occasionally ingest gluten-containing food. We evaluated CD patients reporting voluntary and occasional transgressions to their GFD. METHODS: From October 2017 to September 2018, the patients reporting occasional and voluntary gluten ingestion (GFD-noncompliant) were prospectively enrolled. These patients underwent clinical examination, blood tests, duodenal biopsy, capsule ent...
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#1Ana F. CostaH-Index: 4
#2Emilia SugaiH-Index: 27
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BACKGROUND: Life-long removal of gluten from the diet is currently the only way to manage celiac disease (CeD). Until now, no objective test has proven useful to objectively detect ingested gluten in clinical practice. Recently, tests that determine consumption of gluten by assessing excretion of gluten immunogenic peptides (GIP) in stool and urine have been developed. Their utility, in comparison with conventional dietary and analytical follow-up strategies, has not been fully established. AIM:...
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#1Brandon M. WelchH-Index: 15
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Direct-to-consumer (DTC) telemedicine providers has the potential to change the traditional patient-physician relationship. Professional medical organizations recommend that telemedicine exist within the medical home. This study aims to understand patients’ preferences and desires for DTC telemedicine. We conducted a nationwide survey of 4345 survey respondents demographically balanced to represent the United States adult population. The survey consisted of questions assessing the respondents’ a...
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#1María de Lourdes Moreno (University of Seville)H-Index: 18
#2Angel CebollaH-Index: 26
Last. Carolina Sousa (University of Seville)H-Index: 32
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Objective Gluten-free diet (GFD) is the only management for coeliac disease (CD). Available methods to assess GFD compliance are insufficiently sensitive to detect occasional dietary transgressions that may cause gut mucosal damage. We aimed to develop a method to determine gluten intake and monitor GFD compliance in patients with CD and to evaluate its correlation with mucosal damage. Design Urine samples of 76 healthy subjects and 58 patients with CD subjected to different gluten dietary condi...
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#1Lex van Velsen (UT: University of Twente)H-Index: 15
#2Monique Tabak (UT: University of Twente)H-Index: 12
Last. Hermanus J. Hermens (UT: University of Twente)H-Index: 39
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Abstract Background For many eServices, end-user trust is a crucial prerequisite for use. For the telemedicine context however, knowledge about the coming about and measurement of end-user trust is scarce. Objective To develop and validate the PAtient Trust Assessment Tool (PATAT): a survey instrument to quantitatively assess patient trust in a telemedicine service. Methods Informed by focus groups, we developed a survey that includes measurement scales for the following factors: trust in the ca...
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Cited By1
#1Andrea Costantino (Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico)H-Index: 4
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The purpose of the present document is to provide detailed information on the correct and optimal use of digital media to ensure continuity of care for gastroenterological patients in everyday clinical practice, in health emergencies and/or when the patient cannot reach the hospital for other reasons. During the recent COVID-19 pandemic, telemedicine has allowed many patients with chronic diseases to access remote care worldwide, proving to be the ideal solution to overcome restrictions and carr...