Telephone clinics can be effective in helping patients manage coeliac disease during and post-Covid-19, University of Roehampton study reveals

• Thursday, November 5, 2020

A first of its kind study from the University of Roehampton has found that the use of telephone clinics improved adherence to a gluten free diet in adults with coeliac disease while at the same time relieved pressure on NHS services, providing vital data for how patients can be consulted during and post-pandemic.

The research involved 125 patients with coeliac disease in the UK, where the patients who reported difficultly adhering to a gluten-free diet were offered a personalised telephone consultation by Humayun Muhammad, gastroenterologist and Senior Research Fellow at the University of Roehampton. Between February 2018 and February 2019, the research found that the telephone clinic improved patients’ ability to adhere to the gluten free diet for up to 6 months. As such, this service has proven to be a highly effective way to assist those living with coeliac disease in the long-term.

In the study, patients’ level of adherence to a gluten free diet was based on a scoring framework after completing questionnaires at three, six, nine and twelve months following the telephone consultation. Patients involved in the study were split into two groups, one group included those deemed to be adhering to a gluten free diet before the clinics (the control group), and the second group those who were not (the intervention’ group). The findings concluded that 63% of participants in the intervention group showed better adherence to the diet after three months, which remained at 60% after six months (Graph A). Additionally, only 13% and 16% of this group reported ‘consuming gluten over the previous four weeks’ both three and six months post telephone clinic respectively, compared with 47% before (Graph B).

Graphs from the study showing the increased adherence to the gluten-free diet after the telephone clinic and better diet awareness of participants.

Key conclusions drawn from the study suggest that a telephone clinic format should be continued as an offer to patients both now and beyond the current Covid-19 pandemic, as it reduces patient burden in attending outpatient or GP appointments and is time, space and cost effective for the NHS. Indeed, as annual follow-ups are important for patients to continue to follow their gluten free diet and recommended by experts, particularly for those new to it, the resource savings have the potential to be substantial for GP practices. Importantly, the study also provides a framework for further research globally into other ways telephone clinics can be utilised for treatment and advice for patients as NHS and health services come under increasing pressure due to the ongoing pandemic.

Coeliac disease affects approximately one in 100 people in the UK, meaning there are hundreds of thousands of British people living with the disease, which can only be treated by removing all gluten from their diet, requiring substantial changes to lifestyle.

Lead author of the research, Dr Yvonne Jeanes, Registered Dietitian and Principal Lecturer in the Department of Life Sciences at the University of Roehampton, said: “The Covid-19 pandemic has left our NHS facing its biggest challenge in decades and it is crucial that ways of alleviating pressure on health services are identified and explored.

“Our study shines a light on telephone clinics as an intervention for adults with coeliac disease and the positive results provide data for evidence-based practice to follow, both for the foreseeable future and in a post-Covid world. From our findings there is scope for further exploration into how telephone or online clinics can be more widely used in treatments and guidance for patients suffering from a range of diseases which require regular consultation.”

A copy of the full research paper can be accessed here.

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