{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:26:17Z","timestamp":1783945577708,"version":"3.55.0"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,7,23]],"date-time":"2015-07-23T00:00:00Z","timestamp":1437609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>A strict gluten\u2010free diet is the cornerstone of treatment for coeliac disease. Studies of gluten\u2010free diet adherence have rarely used validated instruments. There is a paucity of data on long\u2010term adherence to the gluten\u2010free diet in the adult population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To determine the long\u2010term adherence to the gluten\u2010free diet and potential associated factors in a large coeliac disease referral centre population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a mailed survey of adults with clinically, serologically and histologically confirmed coeliac disease diagnosed \u22655\u00a0years prior to survey. The previously validated Celiac Disease Adherence Test was used to determine adherence. Demographic, socio\u2010economic and potentially associated factors were analysed with adherence as the outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The response rate was 50.1% of 709 surveyed, the mean time on a gluten\u2010free diet 9.9\u00a0\u00b1\u00a06.4\u00a0years. Adequate adherence (celiac disease adherence test score &lt;13) was found in 75.5% of respondents. A higher level of education was associated with adequate adherence (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002) even after controlling for household income (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0220). Perceptions of cost, effectiveness of the gluten\u2010free diet, knowledge of the gluten\u2010free diet and self\u2010effectiveness at following the gluten\u2010free diet correlated with adherence scores (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Long\u2010term adherence to a gluten\u2010free diet was adequate in &gt;75% of respondents. Perceived cost remains a barrier to adherence. Perceptions of effectiveness of gluten\u2010free diet as well as its knowledge, are potential areas for intervention.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13319","type":"journal-article","created":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T03:49:16Z","timestamp":1437709756000},"page":"753-760","source":"Crossref","is-referenced-by-count":89,"title":["Factors governing long\u2010term adherence to a gluten\u2010free diet in adult patients with coeliac disease"],"prefix":"10.1111","volume":"42","author":[{"given":"J.","family":"Villafuerte\u2010Galvez","sequence":"first","affiliation":[{"name":"Celiac Center Division of Gastroenterology Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. R.","family":"Vanga","sequence":"additional","affiliation":[{"name":"Celiac Center Division of Gastroenterology Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Dennis","sequence":"additional","affiliation":[{"name":"Celiac Center Division of Gastroenterology Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Celiac Center Division of Gastroenterology Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"Leffler","sequence":"additional","affiliation":[{"name":"Celiac Center Division of Gastroenterology Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. P.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Celiac Center Division of Gastroenterology Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Celiac Center Division of Gastroenterology Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60254-3"},{"key":"e_1_2_7_3_1","first-page":"42","article-title":"The Oslo definitions for coeliac disease and related terms","volume":"62","author":"Ludvigsson JF","journal-title":"Gut"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.09.008"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOG.0b013e32830edc1e"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2009.03.059"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.06.005"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/003655202753387338"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.232892"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/198025"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2011.12.012"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(03)00302-4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jada.2003.08.027"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2012.01288.x"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.29"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2009.04053.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12098-010-0092-3"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2012.11.007"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-008-0595-1"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2010.03.004"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.08.034"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2009.07.031"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2011.01.026"},{"key":"e_1_2_7_24_1","first-page":"241","article-title":"Quality of life in coeliac disease is determined by perceived degree of difficulty adhering to a gluten\u2010free diet, not the level of dietary adherence ultimately achieved","volume":"20","author":"Barratt SM","year":"2011","journal-title":"J Gastrointestin Liver Dis"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2007.00763.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-277X.2011.01160.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e31816a8c9b"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12893"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-012-0513-z"}],"container-title":["Alimentary Pharmacology &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fapt.13319","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apt.13319","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T22:20:14Z","timestamp":1695507614000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apt.13319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,23]]},"references-count":28,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1111\/apt.13319"],"URL":"https:\/\/doi.org\/10.1111\/apt.13319","archive":["Portico"],"relation":{},"ISSN":["0269-2813","1365-2036"],"issn-type":[{"value":"0269-2813","type":"print"},{"value":"1365-2036","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,7,23]]}}}