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. 2021 Apr 13:8:622514.
doi: 10.3389/fnut.2021.622514. eCollection 2021.

Nutritional and Gastroenterological Monitoring of Patients With Celiac Disease During COVID-19 Pandemic: The Emerging Role of Telemedicine and Point-of-Care Gluten Detection Tests

Andrea Costantino  1   2 , Leda Roncoroni  1   2   3 , Daniele Noviello  4 , Nicoletta Nandi  4 , Vincenza Lombardo  1   2 , Alice Scricciolo  1   2 , Lucia Scaramella  1   2 , Maurizio Vecchi  1   2   4 , Luca Elli  1   2
Affiliations

Nutritional and Gastroenterological Monitoring of Patients With Celiac Disease During COVID-19 Pandemic: The Emerging Role of Telemedicine and Point-of-Care Gluten Detection Tests

Andrea Costantino et al. Front Nutr. .

Abstract

Background and Aims: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, telemedicine has been supporting many patients with chronic diseases worldwide. However, data on celiac disease (CeD) nutritional and gastroenterological remote monitoring are scanty. The aims of our study were to verify patients' trust in telemedicine and to evaluate the feasibility of telemedicine in nutritional monitoring. Material and Methods: We used telemedicine in place of the scheduled but not provided follow-up visits during the first lockdown of the COVID-19 pandemic. Patients received a phone call, and televisits were conducted for CeD patients with mild or moderate symptoms and/or with blood alterations. The patient's adherence to the gluten-free diet (GFD) was evaluated according to the Celiac Dietary Adherence Test (CDAT). When gluten contamination was suspected, a point-of-care gluten detection test was prescribed. The patient's trust in telemedicine was assessed, through an adapted version of the Patient Trust Assessment Tool (PATAT) questionnaire, as the percentage of patients giving a score of at least 4 out of 5 on a Likert scale for three selected key statements: "I can trust televisit," "I can trust that possible problems with the telemedicine service will be solved properly," and "I feel at ease when working with this website." Results: One hundred and twelve CeD patients were phone called; among symptomatic patients, 39 out of the 42 scheduled (92.9%) televisits were performed. Among the 39 visits, 34 (87.2%) questionnaires were compiled. The patients included in the study obtained a CDAT score from 7 to 13 (11 ± 2). Gluten detection tests were prescribed to 11 patients, resulting positive in 2. Trust in the telemedicine service was achieved in 94.1, 88.2, and 97.1% for the three selected key statements of the PATAT questionnaire. Conclusion: During the COVID-19 pandemic, telemedicine showed to be feasible and the majority of patients trusted the combined gastroenterological and nutritional televisits. Gluten detection tests demonstrated to be useful tools for the patient and for the caregiver to confirm adherence to the GFD remotely.

Keywords: COVID-19; celiac disease; gluten detection test; gluten free diet; nutrition; telehealth; telemedicine; televisits.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Radar chart of the trust scores from celiac patients assessed through an adapted version of the Patient Trust Assessment Tool (PATAT) questionnaire. Five trust areas were investigated: care organization (1.1–1.5), care professionals (2.1–2.5), treatment (3.1–3.5), technology (4.1–4.5), and telemedicine services (5.1–5.5). The dotted line refers to the patients giving a score ≥4 (out of 5) on a Likert scale. The continuous line refers to the patients giving a score ≤ 3. Statements 2.5, 3.4, 5.3, and 5.5 were negative. Regarding trust in telemedicine services, items 5.1, 5.2, and 5.4 received a score of least 4 in 95, 90, and 84% of the cases, respectively.
See this image and copyright information in PMC

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