Pharmacists and pharmacy technicians provide invaluable contact and support for patients with a diagnosis of Coeliac Disease.
NICE QS134 Recognition, assessment and management of coeliac disease in children, young people and adults state that “service providers should consider innovative approaches to undertaking reviews”. Pharmacy staff are ideally placed to undertake these reviews and fulfil this role.
Most adult patients will be followed up by GI services until clinically stable. This is typical until 12 months after diagnosis; thus a health check will not be required until 24 months after diagnosis. To date, the health check is not for those with DH; however many patients with DH will also be diagnosed with coeliac disease, and they are therefore eligible.
In keeping with Statement 5 of the NICE document, the annual health check should be offered to all people with coeliac disease aged over 16.
It states that an annual review for people with coeliac disease should include:
- Measuring weight and height.
- Review of symptoms.
- Considering the need for assessment of diet and adherence to the gluten-free diet.
- Considering the need for specialist dietetic and nutritional advice.
- Considering the need for referral to a GP to address any concerns about possible complications or comorbidities.
All these points are covered by the gluten-free foods annual health check. PCR Version 12(May 2017) contains revised information about the health check. While completing the health check, you may find that the unit allocation has changed as the patient has moved into a different age band. If there are any concerns about knowledge, adherence to the gluten-free diet or ongoing symptoms, a referral should be made to the dietician or GP for further action.
As part of the completion process, the date of the next health check must be specified, and it is essential that the PCR is signed off. If this is not done, it looks like the health check has not taken place. Generally, although there is no official capture regarding health check uptake, it is less than ideal. Health professionals, such as dietitians, encourage patients to ask their pharmacist if they have not had their health check done.
Comments from the Government 2015 report on GFFS stated that while beneficial; they were found by some pharmacists to be time-consuming and involved raising sensitive issues. This needs to be addressed, and more needs to be done to ensure that this very important aspect of the GFFS is carried out.
It is known that if someone takes an interest in a patient’s coeliac disease, they are more likely to adhere to the diet and reduce the risk of long-term complications from not following the diet.