E-Healthcare for Celiac Disease-A Multicenter Randomized Controlled Trial

Area of Science:

• Gastroenterology and Hepatology
• Digital Health
• Health Services Research

Background:

• Celiac disease (CD) management requires regular follow-up to monitor symptoms, growth, and adherence to a gluten-free diet.
• Traditional outpatient consultations may be resource-intensive, prompting investigation into alternative models.
• Online consultations offer a potential avenue for efficient and effective patient care.

Purpose of the Study:

• To evaluate the cost-effectiveness and clinical outcomes of online consultations versus traditional outpatient follow-up for patients with celiac disease.
• To compare health-related quality of life (HRQOL), dietary adherence, patient satisfaction, and costs between the two follow-up methods.

Main Methods:

• A multicenter randomized controlled trial involving 304 pediatric and young adult CD patients.
• Patients were randomized to either online consultations (including questionnaires and point-of-care antibody testing) or standard outpatient consultations.
• Outcomes assessed included anti-transglutaminase-type-2 antibodies, health problems, growth, dietary adherence, HRQOL, patient satisfaction, and costs over six months.

Main Results:

• The point-of-care test demonstrated inferior performance compared to laboratory testing.
• Online consultations led to significantly more frequent detection of health problems.
• Health-related quality of life improved in the online consultation group, and these consultations were associated with significantly lower costs (€202 per participant).

Conclusions:

• Despite the unreliability of the point-of-care test, online consultations are a cost-saving strategy for managing celiac disease in young patients.
• Online follow-up was associated with improved CD-specific HRQOL and high patient satisfaction.
• The majority of participants expressed a desire to continue using online consultations for their follow-up care.