Does a Coeliac School increase psychological well-being in women suffering from coeliac disease, living on a gluten-free diet?

Abstract

Aim and objective. To assess the effects of an active method of patient education on the psychological well-being of women with coeliac disease in remission. Background. Despite remission with a gluten-free diet, adults with coeliac disease and especially women experience a subjective poor health. Self-management education seems to be promising tool to help patients suffering from coeliac disease to cope with their disorder. Design. A randomised controlled trial. Methods. A total of 106 women, ≥20years, with confirmed coeliac disease, who had been on a gluten-free diet for a minimum of five years. The intervention group (n=54) underwent a 10-session educational programme, 'Coeliac School', based on problem-based learning. The controls (n=52) received information regarding coeliac disease sent home on a regular basis. The primary outcomes were psychological general well-being measured with a validated questionnaire. Results. Participants in the Coeliac School reported a significant improvement in psychological well-being at 10weeks, whereas the controls given usual care reported a worsening in psychological well-being. After sixmonths, a significant improvement remained for the index of vitality. Conclusions. Patient education increased psychological well-being in women with coeliac disease. There is a need to refine the methods of patient education to make the effects of well-being more pronounced over time. Relevance to clinical practice. Patient education using problem-based learning promotes self-management in coeliac disease by improving the well-being of patients who have been struggling with the gluten-free diet for years. © 2011 Blackwell Publishing Ltd.