Rej Anupam, Buckle Rachel Louise, Shaw Christian Charles, Trott Nick, Urwin Heidi, McGough Norma, Aziz Imran, Sanders David Surendran
Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
Coeliac UK, High Wycombe, Buckinghamshire, UK.
Frontline Gastroenterol. 2020 Jun 16;12(5):380-384. doi: 10.1136/flgastro-2020-101493. eCollection 2021.
The aim of the study was to assess the provision of dietetic services for coeliac disease (CD), irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD).
Hospitals within all National Health Service trusts in England were approached (n=209). A custom-designed web-based questionnaire was circulated via contact methods of email, post or telephone. Individuals/teams with knowledge of gastrointestinal (GI) dietetic services within their trust were invited to complete.
76% of trusts (n=158) provided GI dietetic services, with responses received from 78% of these trusts (n=123). The median number of dietitians per 100 000 population was 3.64 (range 0.15-16.60), which differed significantly between regions (p=0.03). The most common individual consultation time for patients with CD, IBS and IBD was 15-30 min (43%, 44% and 54%, respectively). GI dietetic services were delivered both via individual and group counselling, with individual counselling being the more frequent delivery method available (93% individual vs 34% group). A significant proportion of trusts did not deliver any specialist dietetic clinics for CD, IBS and IBD (49% (n=60), 50% (n=61) and 72% (n=88), respectively).
There is an inequity of GI dietetic services across England, with regional differences in the level of provision and extent of specialist care. Allocated time for clinics appears to be insufficient compared with time advocated in the literature. Group clinics are becoming a more common method of dietetic service delivery for CD and IBS. National guidance on GI dietetic service delivery is required to ensure equity of dietetic services across England.
本研究旨在评估为乳糜泻（CD）、肠易激综合征（IBS）和炎症性肠病（IBD）提供的饮食服务情况。
联系了英格兰所有国民健康服务信托机构中的医院（共209家）。通过电子邮件、邮寄或电话等联系方式发放一份定制的基于网络的调查问卷。邀请各信托机构中了解胃肠（GI）饮食服务的个人/团队填写。
76%的信托机构（n = 158）提供GI饮食服务，其中78%的信托机构（n = 123）回复了问卷。每10万人口中营养师的中位数为3.64（范围为0.15 - 16.60），不同地区之间存在显著差异（p = 0.03）。CD、IBS和IBD患者最常见的个体咨询时间为15 - 30分钟（分别为43%、44%和54%）。GI饮食服务通过个体咨询和团体咨询两种方式提供，个体咨询是更常用的方式（93%为个体咨询，34%为团体咨询）。相当一部分信托机构没有为CD、IBS和IBD开设任何专科饮食诊所（分别为49%（n = 60）、50%（n = 61）和72%（n = 88））。
英格兰各地的GI饮食服务存在不公平现象，在服务提供水平和专科护理程度上存在地区差异。与文献中提倡的时间相比，诊所分配的时间似乎不足。团体诊所正成为CD和IBS饮食服务提供的一种更常见方式。需要制定关于GI饮食服务提供的国家指南，以确保英格兰各地饮食服务的公平性。
