Abstract：
BACKGROUND: A lifelong gluten-free (GF) diet to manage coeliac disease is recognised to be challenging. This paper comprises two studies: study one aimed to report the opinions of adults with coeliac disease on review provision and explore factors influencing dietary adherence. Study two aimed to report dietetic provision for adults with coeliac disease.
METHODS: A cross-sectional online survey was completed by 722 adults with coeliac disease, including validated dietary adherence, health literacy and quality-of-life questionnaires. An online and paper survey designed to capture the provision of dietetic services to adults with coeliac disease was completed by 88 dietetic departments within the United Kingdom.
RESULTS: Only 26% of adults with coeliac disease were offered annual reviews. In contrast, 85% considered reviews important, with 62% preferring dietetic provision. Those who considered reviews important had lower health literacy, greater dietary burden, poorer GF dietary adherence and lower GF food knowledge (all p < 0.05) compared with those who did not consider reviews important. GF dietary adherence was associated with health literacy, self-regulatory behaviours, dietary burden and GF food knowledge; 53% agreed with the \'cost of GF food restricts what I eat\'; they had poorer GF dietary adherence compared with those who disagreed (p < 0.001). More than 72% of dietetic coeliac review provision provided content on improving access to GF foods and eating out of the home.
CONCLUSIONS: A subpopulation of adults with coeliac disease have a greater need for support and guidance, which supports the viewpoint that limited resources should be targeted towards patients with the most need for support to enable successful disease management.
METHODS: A cross-sectional online survey was completed by 722 adults with coeliac disease, including validated dietary adherence, health literacy and quality-of-life questionnaires. An online and paper survey designed to capture the provision of dietetic services to adults with coeliac disease was completed by 88 dietetic departments within the United Kingdom.
RESULTS: Only 26% of adults with coeliac disease were offered annual reviews. In contrast, 85% considered reviews important, with 62% preferring dietetic provision. Those who considered reviews important had lower health literacy, greater dietary burden, poorer GF dietary adherence and lower GF food knowledge (all p < 0.05) compared with those who did not consider reviews important. GF dietary adherence was associated with health literacy, self-regulatory behaviours, dietary burden and GF food knowledge; 53% agreed with the \'cost of GF food restricts what I eat\'; they had poorer GF dietary adherence compared with those who disagreed (p < 0.001). More than 72% of dietetic coeliac review provision provided content on improving access to GF foods and eating out of the home.
CONCLUSIONS: A subpopulation of adults with coeliac disease have a greater need for support and guidance, which supports the viewpoint that limited resources should be targeted towards patients with the most need for support to enable successful disease management.
摘要：
背景：终生无麸质（GF）饮食来管理乳糜泻被认为是具有挑战性的。本文包括两项研究：一项研究旨在报告患有乳糜泻的成年人对综述提供的看法，并探讨影响饮食依从性的因素。研究二旨在报告患有乳糜泻的成年人的饮食供应。
方法：一项横断面在线调查由722名患有乳糜泻的成年人完成，包括经过验证的饮食依从性，健康素养和生活质量问卷。英国的88个饮食部门完成了一项旨在捕获向患有乳糜泻的成年人提供饮食服务的在线和纸质调查。
结果：只有26%的乳糜泻成人接受了年度审查。相比之下,85%的人认为评论很重要，62%的人更喜欢饮食供应。那些认为评论重要的人的健康素养较低，更大的饮食负担，与那些不认为评论重要的人相比，GF饮食依从性较差，GF食物知识较低（所有p<0.05）。GF饮食依从性与健康素养相关，自我调节行为,饮食负担和GF食品知识;53％同意“GF食品的成本限制我吃什么”;与不同意的人相比，他们的GF饮食依从性较差（p<0.001）。超过72％的饮食乳糜泻审查规定提供了改善获取GF食品和外出就餐的内容。
结论：乳糜泻成人亚群更需要支持和指导，这支持这样的观点，即有限的资源应该针对最需要支持的患者，以实现成功的疾病管理。
方法：一项横断面在线调查由722名患有乳糜泻的成年人完成，包括经过验证的饮食依从性，健康素养和生活质量问卷。英国的88个饮食部门完成了一项旨在捕获向患有乳糜泻的成年人提供饮食服务的在线和纸质调查。
结果：只有26%的乳糜泻成人接受了年度审查。相比之下,85%的人认为评论很重要，62%的人更喜欢饮食供应。那些认为评论重要的人的健康素养较低，更大的饮食负担，与那些不认为评论重要的人相比，GF饮食依从性较差，GF食物知识较低（所有p<0.05）。GF饮食依从性与健康素养相关，自我调节行为,饮食负担和GF食品知识;53％同意“GF食品的成本限制我吃什么”;与不同意的人相比，他们的GF饮食依从性较差（p<0.001）。超过72％的饮食乳糜泻审查规定提供了改善获取GF食品和外出就餐的内容。
结论：乳糜泻成人亚群更需要支持和指导，这支持这样的观点，即有限的资源应该针对最需要支持的患者，以实现成功的疾病管理。
