An annual review provides specialist Coeliac Disease (CD) dietitians and service users the opportunity to monitor adherence to a gluten free diet. This study aimed to evaluate a digital virtual annual review tool (VAR) as an alternative method of reviewing clinically stable adults living with CD; by investigating the response rate and impact on dietetic time.
A single center retrospective study included adult services users living with CD >3 years requiring an annual review. Service users accessed the digital VAR through a secure link via DrDoctor software between September 2022 - March 2024. The innovative tool, developed by dietitians, consultants and service user experienced in CD, assessed symptoms, dietary adherence, quality of life, satisfaction and preferred follow-up approach. Chi squared analysis examined associations between response rates and demographics with a P <0.05. Dietetic review time was reported using interquartile range (IQR), with outcomes presented as frequencies and percentages. Ethical approval was obtained from local University, and information governance approval was received through local NHS trust procedures.
The majority (81.7%; n=165) of service users engaged with the digital VAR tool, with demographics not influencing response rates (age P 0.11, biological sex P 0.42, ethnicity P 0.27 and years since diagnosis P 0.20). The median triage time of the VAR tool was 14 minutes (IQR 10.5-15minutes). 22% (n=31) required a dietetic follow-up clinic appointment to explore further symptoms or dietary adherence. Service users mainly preferred the VAR tool for future dietitian annual reviews (55%, n=78).
Digital assessments may provide a more efficient and patient-accepted way of annually reviewing clinically stable adults living with CD, whilst meeting current international follow-up recommendations. Using patient self-assessment for triage saves time, enabling dietetic resources to be used more efficiently.