Effectivenes of a track-based model for treating eating disorders in a general psychiatric hospital

Wagner, Rebecca; MacCaughelty, Chelsea R.; Rufino, Katrina A.; Pack, Tessa; Poplack, Janice; Kim, George; Ruscitti, Catherine

doi:10.1521/bumc.2016.80.1.49

Cited by 3 publications

(5 citation statements)

References 10 publications

(11 reference statements)

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“…The findings of this RR suggest the presence of specialist ED services in the system may help optimise patient outcomes [ 42 , 98 ] by aiding in ED detection and referral [ 28 , 39 ], and reducing mortality rates [ 30 ]. Further, evidence suggests ED patients may be effectively treated in both inpatient and outpatient/community settings with MDTs [ 39 , 80 , 83 ].…”

Section: Discussionmentioning

confidence: 99%

“…Reduced hospitalisation may result in further cost savings [ 63 ] and lessen the strain on resources for inpatient care [ 57 , 99 ], while improving QoL during recovery for those safe to receive adequate treatment and follow up in the community setting [ 32 ]. Although some patients may be effectively treated in primary care and non-specialist settings, it remains critical that these specialist ED services are available to support the system and provide acute care for complex cases [ 98 ], particularly for those with more rapid weight loss, such as those with past obesity, as this can infer medical risk [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

“…NICE guidelines [ 106 ] stress the importance of discussing psychological treatment options with patients and providing a referral to specialist ED services for timely assessment and treatment. Also aligned with NICE guidelines [ 106 ], this RR found timely referral to specialist ED care may optimise patient care [ 28 , 30 , 39 , 42 , 98 ]. According to NICE guidelines [ 106 ], equally important to the standard of care is how specialist services communicate and interact with each other and the patient, along with the provision of detailed care plans outlining how the different services supporting the individual will work collaboratively [ 106 ].…”

Section: Discussionmentioning

confidence: 99%

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Models of care for eating disorders: findings from a rapid review

Pehlivan

Miskovic‐Wheatley

Le³

et al. 2022

J Eat Disord

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Background Delayed diagnosis, gaps in services and subsequent delays in specialist care and treatment lead to poorer health outcomes for individuals with eating disorders (EDs) and drive significant government healthcare expenditure. Given the significant disease burden associated with EDs, it is imperative that current implementation research is summarised to identify gaps in care and enable refinement for optimal patient outcomes. This review aimed to provide an updated synthesis on models of care for EDs in developed healthcare systems. Methods This paper was conducted as part of a series of Rapid Reviews (RRs) to be published in a special series in the Journal of Eating Disorders. To provide a current and rigorous review, peer-reviewed articles published in the English language between 2009 and 2021 across three databases (ScienceDirect, PubMed and Ovid/Medline) were searched, with priority given to higher level evidence (e.g., meta-analyses, large population studies, Randomised Control Trials (RCTs)). The current review synthesises data from included studies investigating models of care for people with EDs. Results Sixty-three studies (4.5% of the original RR) were identified, which included several diagnostic populations, the most common being Anorexia Nervosa (AN) (30.51%). Across EDs, specialist care was found to improve patient outcomes, with many patients effectively being treated in outpatient or day programs with multi-disciplinary teams, without the need for lengthy inpatient hospitalisation. Few studies investigated the interaction of different ED services (e.g., inpatient, community services, primary care), however stepped care models emerged as a promising approach to integrate ED services in a targeted and cost-effective way. Issues surrounding low treatment uptake, underdiagnosis, long waiting lists and limited hospital beds were also evident across services. Conclusion Findings suggested further research into alternatives to traditional inpatient care is needed, with partial and shorter ‘hospitalisations’ emerging as promising avenues. Additionally, to tackle ongoing resource issues and ensure timely detection and treatment of EDs, further research into novel alternatives, such as active waiting lists or a greater role for primary care clinicians is needed. Plain English summary This paper is part of a larger Rapid Review series carried out to guide Australia’s National Eating Disorders Research and Translation Strategy 2021–2031. Rapid reviews aim to thoroughly summarise an area of research over a short time period, typically to help with policymaking in this area. This Rapid Review summarises the evidence relating to how we care for people with eating disorders in Western healthcare systems. Topics covered include inpatient/hospital care, residential care, day programs, outpatient/community care, and referral pathways. Findings suggested specialist eating disorder services may enhance detection, referral, and patient care. Stepped care models presented as a cost-effective approach which may help with linkage between different eating disorder services. There was a trend towards shorter hospital stays and approaches which allow for greater connection with the community, such as day programs. Evidence was also found of treatment delays, due to system issues (long waiting lists, lack of accurate assessment and diagnosis) and patient-related barriers (stigma, recognition). Upskilling and involving primary care clinicians in diagnosis and referral as part of a stepped care model may help to address some of these concerns. Further efforts to improve mental health literacy and de-stigmatise help-seeking for eating disorders are needed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Models of care for eating disorders: findings from a rapid review

Pehlivan

Miskovic‐Wheatley

Le³

et al. 2022

J Eat Disord

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“…The EDI has also been shown to be sensitive to individual changes in response to treatment (e.g. Wagner et al, 2016). This measure was administered at pre- and post-treatment and questions were anchored to the past week.…”

Section: Methodsmentioning

confidence: 99%

Effects of an Appearance-Focused Interpretation Training Intervention on Eating Disorder Symptoms

Summers

Cougle

2018

Behav. Cogn. Psychother.

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“…The only significant correlation between the participants' clinical data and EDI-3 scale scores was unexpectedly a negative relationship between BMI-for-age percentile and Personal Alienation, indicating the more severe the AN, the more participants felt alienated from themselves (e.g., feeling a sense of emptiness or having difficulties developing a sense of self; Garner, 2004). It may therefore be beneficial for individuals with AN to engage in treatment implementing a biopsychosocial model (e.g., Wagner et al, 2016). For example, Wagner and colleagues 2016…”

Section: Discussionmentioning

confidence: 99%

The neuropsychological functioning of children and adolescents with anorexia nervosa

Chang¹

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services in the data analysis process, including addressing missing data and ensuring the accuracy of the statistical analyses. My journey throughout graduate school would not have been the same without the support of my friends and other loved ones in Iowa and across the country. To Matt, thank you for your immense support during this process and helping me keep my "eyes on the prize." To Victoria, I am extremely grateful for your optimism and reminding me of my strengths when times were stressful. To my graduate school and internship cohort-mates, thank you for your assistance in this process and making working endless weekends in coffee shops and other workplaces more enjoyable. And to my friends back home, thank you for providing me the fuel to continue graduate school and helping me anchor myself.

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Effectivenes of a track-based model for treating eating disorders in a general psychiatric hospital

Abstract: [49][50][51][52][53][54][55][56][57][58][59]

Cited by 3 publications

References 10 publications

Models of care for eating disorders: findings from a rapid review

Models of care for eating disorders: findings from a rapid review

Effects of an Appearance-Focused Interpretation Training Intervention on Eating Disorder Symptoms

The neuropsychological functioning of children and adolescents with anorexia nervosa

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