Background: Coeliac disease (CD) affects approximately 1 in 70 Australians1, with timely diagnosis and early dietetic intervention critical to reducing risks of impaired growth, nutritional deficiencies, and psychosocial burden. Traditional diagnostic pathways require multiple medical appointments before dietetic referral, delaying care and increasing system inefficiencies. Enabling dietitians to work to full scope, incorporating diagnostic assessment and management, offers an opportunity to streamline care. This study evaluated a Dietitian-Led Coeliac Clinic (DLCC) to reduce diagnostic and treatment delays.
Methods: A small‑scale pilot DLCC was implemented in April 2026, with outcomes compared to the traditional medically led model (MLM; Jan–Dec 2019). Data were extracted from ieMR to quantify care pathway metrics. Pathway duration (time from gastroenterology referral to completion of dietetic education following diagnosis), and diagnostic timeliness (time from referral to confirmed diagnosis (ESPGHAN non-biopsy criteria2)) were calculated using data from the ieMR. Attendance data were used to determine dietetic did not attend (DNA) rates.
Results: A total of 15 patients were tracked across their full care journey under the MLM and 7 patients under the DLCC. Total pathway duration was reduced by over 100days under the DLCC (median 125days MLM vs 21days DLCC). Diagnostic timeliness improved by 67 days (median 88days MLM vs 21days DLCC). High DNA rates under the MLM (40%) were eliminated under the DLCC.
Conclusion: The DLCC model markedly reduced pathway delays and non-attendance, improving efficiency and engagement in paediatric coeliac care. Further evaluation in larger cohorts is required, incorporating statistical testing, patient and clinician satisfaction, and cost effectiveness.