GPs ‘under-prescribing gluten-free foods’ for coeliac disease
GPs under prescribe gluten-free (GF) foods for patients with coeliac disease and do not follow national prescribing guidelines, according to a Scottish study.
The study is the first to look at the quantities of GF food prescribed by GPs and compare them with the monthly allowance recommended in prescribing guidelines by Coeliac UK Primary Care Society for Gastroenterology and the British Dietetic Association. From April 2010 to March 2011, researchers evaluated retrospectively the GP electronic medical records of patients registered at 16 GP practices in the west of Scotland.
Of the total number of patients registered (85,667), 175 were prescribed GF foods and/or had a diagnosis of coeliac disease or dermatitis herpetiformis (DH). Some 102 patients (61%) of the patients with a recorded diagnosis of gluten-sensitive enteropathy received GF foods on prescription while 64 (37%) did not receive any GF foods on prescription.
There was variation in the number of GF food products received on prescription; the mean number was two while some individuals (34%) were prescribed one to five products per year and others (20%) more than five. According to Coeliac UK guidelines, the lowest recommended unit allowance for any adult is 156 units for women >75 years. In this study, most individuals (82%) received between 0.75 to 155 units of GF foods on prescription over one year.
What does this study mean for GPs?
The author comment: ‘The present study has provided a unique evaluation of the prescribing of GF foods within one health authority in the UK, highlighting the need to ensure that all individuals receiving GF foods on prescription have a confirmed diagnosis of a gluten-sensitive enteropathy’.