Current Knowledge, Attitude, and Practices of Pediatric Gastroenterologists in the Management of Celiac Disease - A Survey Study

Abstract

Abstract Introduction: Celiac Disease (CD) is a common autoimmune disorder characterized by an immune-mediated reaction to gluten. The aim of the study is: 1. To assess the current practices of pediatric gastroenterologists (GI) in the management of CD; 2. To assess how these responses compare to the current EIEBPG; and 3. To assess how the practices vary based upon geographic location. Methods: This study was a cross-sectional survey of members of the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN). After obtaining NASPGHAN and IRB approval, members (n=2400) were sent a SurveyMonkey® survey consisting of 22 questions of which 17 were based upon the Evidence-Informed Expert Best Practice Guidelines (EIEBPG). Results: A total of 8.3% (198/2400) responders completed the survey. Respondents from North America (NA) comprised the largest group, 80.8% (160/198), followed by 7.6% (15/198) European (EU) responders. When indicated, Human Leukocyte Antigen (HLA) typing was used by 11 (5.6%) responders on all visits. Comparing respondents from NA and EU on the majority of visits, 141/160 (88.1%), 59/160 (36.9%), and 153/160 (95.6%) respondents from NA screened for Vitamin D, Hepatitis B Virus (HBV) immunization, and had access to dietician respectively, compared to 7/15 (46.7%), 2/15 (13.3%), and 9/15 (60%) EU respondents, respectively. Conclusion: Overall, most study respondents were reportedly adhering to EIEBPG. Providers need to utilize HLA typing more for patients with negative serology. EU providers need to be more consistent for screening for vitamin D and there is room for improving access to dietitians of EU celiac disease patient’s clinic visits.