Awareness and Practice Patterns of Celiac Disease Among Family Physicians: A Questionnaire-Based Study in Relation to Years in Practice and Awareness of Local Guidelines

Abstract

To evaluate awareness and practice patterns of family physicians regarding celiac disease (CD), in relationto years in practice and awareness of local guidelinesMethods: A total of 147 family physicians (mean age 39.4 years, range, 24 to 64 years and 52.4% were female)working in primary care clinics across Gaziantep province were included on a voluntary basis in this cross-sectionalquestionnaire-survey. The questionnaire form elicited items on sociodemographic characteristics of physicians (age,gender, years in practice), their awareness of CD (serological tests, screening indications, types of the disease) andpractice patterns in CD including frequency of suspected diagnosis, serological tests, intestinal biopsy, risk of malignancy, gluten-free diet strictness and criteria, IgA screening and awareness of local guidelines. The questionnaireform was applied via face-to-face interview method.Results: Presence of chronic diarrhea (33.7%) was reported to be the most indication for serological analysis andtypical form of the disease (49.8%) was reported to be more commonly recognized. Only 17.7% of physiciansreported that they frequently suspect CD in adult patients, 38.1% reported that they frequently refer patients forserological tests for CD and 36.1% reported that they always recommend intestinal biopsy for serology positivepatients. Overall, 63.5% of physicians considered strict the gluten-free diet to always be applied by patients withCD, 51% reported that they recommend a gluten-free diet to serology negative patient with symptoms similar to CDand 19.7% reported that they recommend IgA screening for patients with CD. No significant difference was notedin practice pattern variables with respect to years in practice, while the likelihood of a physician to always recommend intestinal biopsy for serology positive patients (42.7% vs. 27.7%, p=0.028) significantly increased with theawareness of guidelines.Conclusion: In conclusion, our findings indicate low level of awareness about CD in terms of adult-onset and atypicalpresentations and poor knowledge regarding the diagnosis and practice patterns in CD among family physicians,regardless of the years in practice. Accordingly, our findings indicate a need to increase awareness of CD and improveadherence to guidelines via educational sessions and workshops among family physicians, particularly in terms ofthe recognition of adult onset of symptoms, the utility of serological tests combined with intestinal biopsy and proper recommendation of gluten-free diet in individuals with CD