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Open Access Highly Accessed Research article

Impact of symptoms on quality of life before and after diagnosis of coeliac disease: results from a UK population survey

Alastair M Gray1* and Irene N Papanicolas2

Author Affiliations

1 Health Economics Research Centre, Department of Public Health, University of Oxford, Old Road Campus, Oxford, UK

2 LSE Health, London School of Economics and Political Science, Houghton Street, London, UK

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BMC Health Services Research 2010, 10:105  doi:10.1186/1472-6963-10-105

Published: 27 April 2010

Abstract

Background

Coeliac disease is a common chronic autoimmune disorder. Underdiagnosis is common and the quality of life impact of symptoms may be severe. We report a study of symptom duration and quality of life before and after diagnosis in a representative sample of people with diagnosed coeliac disease in the UK.

Methods

Postal questionnaire of 2000 people with diagnosed coeliac disease, requesting information on date of diagnosis, type and duration of symptoms, and quality of life before and after diagnosis using the EQ-5D instrument.

Results

The survey response rate was 40% (788/2000). Mean duration of symptoms prior to diagnosis was 13.2 years, with some evidence of shorter duration in recent years. Respondents reported a mean of 13 consultations with their GP about their symptoms prior to diagnosis. The mean utility value of pre-diagnosis quality of life was 0.56, compared to 0.84 at time of survey, a highly statistically significant improvement of 0.27 (95% c.i. 0.25, 0.30).

Conclusions

The symptoms of undiagnosed coeliac disease are associated with a prolonged and substantial decrement to quality of life. These results strengthen the case for detailed examination of the cost-effectiveness of improved methods of detection and diagnosis, including population screening.