A randomized controlled trial of an online intervention to improve gluten-free diet adherence in celiac disease

Am J Gastroenterol. 2013 May;108(5):811-7. doi: 10.1038/ajg.2013.47. Epub 2013 Mar 5.


Objectives: To test the effectiveness of an interactive online intervention to improve gluten free diet adherence in adults with celiac disease.

Methods: A Randomized controlled trial was conducted. A total of 189 adults with biopsy-confirmed celiac disease were recruited and randomized to receive the intervention (n=101) or to a waitlist control condition (n=88). Post-intervention data was available for 70 intervention and 64 waitlist participants. Three month follow-up data was obtained for 46/50 completers from the intervention group. The primary outcome measure was gluten-free diet adherence. Secondary outcomes were gluten-free diet knowledge, quality of life and psychological symptoms.

Results: Results were based on intention-to-treat analyses. The intervention group evidenced significantly improved gluten-free diet adherence, and gluten-free diet knowledge following the treatment period relative to the waitlist control group. The change in knowledge did not contribute to the change in adherence. These improvements were maintained at 3-month' follow-up.

Conclusions: The online program was effective in improving adherence and represents a promising resource for individuals with celiac disease who are struggling to achieve or maintain adequate gluten free diet adherence.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Biopsy
  • Celiac Disease / diagnosis
  • Celiac Disease / diet therapy*
  • Celiac Disease / psychology*
  • Computer-Assisted Instruction*
  • Diet, Gluten-Free*
  • Female
  • Follow-Up Studies
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Patient Compliance / statistics & numerical data*
  • Quality of Life*
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Waiting Lists