title: Benefit on health-related quality of life of adherence to gluten-free diet in adult patients with celiac disease.
abstract: BACKGROUND
  Celiac disease (CD) affects health-related quality of life (HRQOL) of patients suffering it. The exclusion of gluten from the diet (GFD) improves HRQOL, but involves difficulties in following the diet that could adversely affect HRQOL.
  
  
  OBJECTIVE
  To determine the effect of adherence to the diet on HRQOL of adult CD patients.
  
  
  METHODS
  A prospective, cross-sectional, multicenter study of CD patients treated with a GFD for longer than 1 year. Adherence to the GFD was measured using the Morisky scale, and health status using the specific CD-QOL questionnaire and the generic EuroQol-5D questionnaire.
  
  
  RESULTS
  366 patients from 7 hospitals were included: 71.5% of patients reported a perfect treatment adherence, 23.5% unintentional poor adherence and 5% intentional poor adherence. Good adherence to a GFD was related to a higher mean score onthe CD-QOL (75 vs. 68, respectively, p < 0.05) and EuroQol-5D (0.9 vs. 0.8, respectively, p < 0.05). Ease of adherence to a GFD was also related to a better HRQOL (total CD-QOL score of 82 vs. 67 in patients who consider the GFD difficult to follow, p < 0.05). Good symptom control was also related to a better HRQOL (total CD-QOL score of 78 vs. 67 in asymptomatic vs. symptomatic patients, p < 0.01). The worse scored dimension of CD-QOL was related to "inadequate treatment".
  
  
  CONCLUSIONS
  In CD, good adherence to a GFD and adequate symptom control result in improved HRQOL. Many patients consider that the lack of therapeutic alternatives to diet worsens their quality of life.
authors.forename: Francisco
authors.initials: F
authors.lastname: Casellas
authors.forename: Luis
authors.initials: L
authors.lastname: Rodrigo
authors.forename: Alfredo J
authors.initials: AJ
authors.lastname: Lucendo
authors.forename: Fernando
authors.initials: F
authors.lastname: Fernández-Bañares
authors.forename: Javier
authors.initials: J
authors.lastname: Molina-Infante
authors.forename: Santiago
authors.initials: S
authors.lastname: Vivas
authors.forename: Mercé
authors.initials: M
authors.lastname: Rosinach
authors.forename: Carmen
authors.initials: C
authors.lastname: Dueñas
authors.forename: Josefa
authors.initials: J
authors.lastname: López-Vivancos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002446:Celiac Disease / Q000178:diet therapy* / Q000523:psychology; D003430:Cross-Sectional Studies; D055050:Diet, Gluten-Free / Q000523:psychology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D055815:Young Adult