RESUMEN
Celiac disease (CD) is often diagnosed in childhood, and the treatment is a lifelong gluten-free diet (GFD).1,2 It may take several years to gain competence in the skills required to follow a GFD successfully. Inadequately treated CD is associated with bone fractures, nutritional deficiencies, and lymphoma.3,4 Healthcare providers are key resources for patients with CD. Consultation with a dietitian with GFD expertise at diagnosis and annual disease-specific follow-up care are recommended.2,5 The primary objective of this study was to evaluate adherence to guidelines for dietitian consultation and follow-up for children with CD. A secondary objective was to identify factors associated with loss to follow-up.
Asunto(s)
Enfermedad Celíaca/epidemiología , Continuidad de la Atención al Paciente , Perdida de Seguimiento , Adolescente , Factores de Edad , Niño , Estudios de Cohortes , Femenino , Humanos , Masculino , Medicaid , Nutricionistas , Derivación y Consulta/estadística & datos numéricos , Estudios Retrospectivos , Hermanos , Estados Unidos/epidemiologíaRESUMEN
Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) adults experience a wide variety of unique challenges accessing healthcare. These barriers may be exacerbated among older LGBTQ+ people due to intersecting, marginalized identities. To prepare physicians to address the healthcare needs of older LGBTQ+ adults, graduate medical education (GME) must include training about the specific needs of this population. Prior studies demonstrate a lack of LGBTQ+ training in GME curricula. Here, we investigated the presence of LGBTQ+ curricula in internal medicine residencies and geriatrics fellowships through a national survey. Over 62.0% of internal medicine (n = 49) and 65.6% (n = 21) of geriatric medicine fellowship program directors, responding to the survey, reported content relevant to the health of older LGBTQ+ adults. Education about LGBTQ+ health in internal medicine residencies and geriatrics fellowships is vital for the provision of culturally-competent healthcare and to create an inclusive environment for older LGBTQ+ patients.