It is usually advised to assess adherence to a gluten-free diet in celiac disease (CD). There is little information available concerning the implications of transitioning from the referral centre to the general paediatrician (GP) once remission has been established. Adherence was evaluated in individuals referred to the GP for a yearly check-up and then called back for re-evaluation. Immunoglobulin A (IgA), antitissue transglutaminase (anti-tTG), and the Biagi score (BS) were measured at the referral centre (V1) and at re-evaluation (V2). Patients were divided into 2 groups: adherent and nonadherent. Adherence scores were associated with personal and clinical data. The study assessed 200 patients. Overall, researchers discovered good adherence rates in 94.95 percent of patients at V1 and 83.5 percent of patients at V2. IgA anti-tTG antibodies were negative in 100% of cases at V1 and 96.97% of cases at V2. BS is 3 to 4 in 94.5 percent of V1 and 84 percent of V2. Adherence at V2 was substantially lower than at V1. There were no significant correlations between adherence ratings and sex, symptoms and age at diagnosis, family history of CD, comorbidities, or endoscopic diagnosis. Age 13 or older is a risk factor for noncompliance at V1 and V2, and foreign nationality at V2. 

The BS, serology, and clinical interview, when combined, are valid methods for measuring juvenile gluten-free diet adherence. Researchers believe that sending patients to their primary care physician following CD remission is crucial, but the procedure has to be improved, and suggestions are needed.