Abstract

Aim:To understand the role(s) of New Zealand dietitians in the management of Crohn disease and dietitian experience using exclusive enteral nutrition. Methods:An electronic survey of Dietitians New Zealand members was undertaken. A link to the survey was disseminated through their weekly electronic newsletter. Survey responses were analyzed using descriptive statistics and responses from pediatric and adult dietitians were compared using Fisher's exact test and Chi-squared test. Open ended questions were summarized using thematic analysis. The responses of New Zealand dietitians were compared to dietitian practice internationally and current inflammatory bowel disease standards of care. Results:Seventy-seven dietitians saw patients with gastrointestinal complaints, 58 of whom were referred patients with Crohn disease. Fifty dietitians assessed a case of Crohn disease monthly or a few times a year. Pediatric and adult dietitians predominately received Crohn disease patient referrals for different reasons. Thirty-five dietitians, including 10 pediatric dietitians, had previously used exclusive enteral nutrition to treat active Crohn disease in a median of three patients. Barriers to prescribing exclusive enteral nutrition included limited Crohn disease patient load and limited referrals from gastroenterologists or surgeons. Supplementary enteral nutrition was mostly used to treat nutritional concerns. Dietitians would find useful further professional development on how to use exclusive enteral nutrition, more patient resources, professional support and also more scientific evidence to support its use with adult patients. Conclusions:New Zealand dietitians have limited experience using exclusive enteral nutrition and are possibly underutilized in the multidisciplinary care of Crohn disease patients in New Zealand.

Authors and Affiliations