Introduction The management of Coeliac disease (CD) is through a gluten free diet (GFD). The current BSPGHAN guidelines advise that annual follow-up with both a paediatric dietitian and paediatric gastroenterologist is necessary to ensure continued adherence to a GFD.

However there are many NHS trusts where paediatric patients with CD are only reviewed in a dietetic-led clinic (DLC) annually.

Aims and Objectives To evaluate a DLC for the management of paediatric patients with CD two years after its establishment. In the current service patients are reviewed on an annual basis by the dietitians after an initial post-diagnosis appointment with a paediatric gastroenterologist and if identified as requiring a medical review through the ‘red flag’ criterion they will be referred back to the paediatric gastroenterologist. The objectives of this service evaluation were to assess satisfaction rates with the DLC and establish GFD compliance rates of patients attending the DLC.

Subjects and Methods Patients who had attended the DLC in the previous year were invited to partake in the service evaluation. The method was two online questionnaires. The satisfaction questionnaire had previously been utilised in the same centre to assess satisfaction with the service prior to the change to a DLC service. The dietary compliance questionnaire had previously been utilised in another paediatric study.

Results The patient population response rate was 40% (n=28). 61% of respondents were ‘extremely likely’ to recommend the DLC to friends and family if similar care was needed. 61% of respondents were ‘fully compliant’, 32% of respondents were ‘compliant with errors’ and 7% of respondents were ‘non-compliant’ with a GFD. 79% were ‘fully compliant’ in the age-group 3–11 years compared to 43% in the age-group 12–18 years. Chi-square analysis showed this difference was approaching statistical significance (p=0.053). The responses to the question ‘My child eats food labelled ‘May contain traces of gluten or wheat’‘ stratified by the two age-groups showed that 86% of respondents in the age-group 3–11 years responded ‘no’ whereas 50% of the respondents in the age-group 12–18 years responded ‘no’ to this question. Chi-square analysis showed that this difference reached statistical significance (p=0.043).

Summary and Conclusion A comparison between the satisfaction survey results performed prior to the service change shows that there is an increased proportion of respondents from the DLC service who were ‘extremely likely’ to ‘recommend the service to a friend or family member’ (61%) compared to the previous service (38%). During the two year period since the DLC service has been in place, two patients from 70 patients who are reviewed in the DLC required referral to the gastroenterologist. Significant financial savings are associated with a DLC compared with the previous service. The compliance rates of the overall population group and the lower compliance rates in the adolescent sub-group found are in accordance with the available literature. The questionnaire was able to identify some areas where adolescents were falling down in their compliance to a GFD and this informed the development of an online education resource.