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Comparing family‐based treatment with inpatient treatment in youth with anorexia nervosa eligible for hospitalization: A 12‐month feasibility study.

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Title: Comparing family‐based treatment with inpatient treatment in youth with anorexia nervosa eligible for hospitalization: A 12‐month feasibility study.
Authors: Haas, Verena, Wechsung, Katja, Kaiser, Vivien, Schmidt, Janine, Raile, Klemens, Busjahn, Andreas, Le Grange, Daniel, Correll, Christoph U.
Source: International Journal of Eating Disorders. Feb2024, Vol. 57 Issue 2, p388-399. 12p.
Subjects: Anorexia nervosa treatment, Family psychotherapy, Pilot projects, Length of stay in hospitals, Professional practice, Suicide, Clinical trials, Burden of care, Evidence-based medicine, Mann Whitney U Test, Fisher exact test, Treatment effectiveness, Comparative studies, Weight gain, T-test (Statistics), Psychological tests, Hospital care, Research funding, Pathological psychology, Questionnaires, Repeated measures design, Descriptive statistics, Cost effectiveness, Body mass index, Adverse health care events, Data analysis software, Statistical models, Outpatient services in hospitals, Longitudinal method, Self-mutilation, Adolescence
Geographic Terms: Germany
Abstract: Objective: Family‐based treatment (FBT) for youth with anorexia nervosa (AN), has not been compared to inpatient, multimodal treatment (IMT). Method: Prospective, non‐randomized pilot feasibility study of adolescents with AN receiving FBT (n = 31), and as a reference point for exploratory outcome comparisons IMT (n = 31), matched for baseline age and percent median BMI (%mBMI). Feasibility of FBT in youth fulfilling criteria for IMT was assessed via study recruitment and retention rates; acceptability via drop‐out and caregiver strain; safety via adverse events; preliminary treatment effectiveness between groups was assessed via a change in %mBMI, AN psychopathology (Eating Disorder Examination‐Questionnaire, EDE‐Q), and hospital days, over 12 months with intent‐to‐treat, mixed models repeated measures analyses covering post‐intervention usual care until 12 months. Results: Taking into account that 8 FBT patients (25.8%) crossed over to IMT due to lack of weight gain or psychiatric concerns, FBT and IMT were similarly feasible, acceptable, and safe, apart from more physical antagonism toward others in FBT (p =.010). FBT lasted longer (median [interquartile range, IQR]; 33.6 [17.4, 49.9] vs. 17.3 [14.4, 24] weeks, p <.001), but required fewer hospital days than IMT (median, [IQR], FBT = 1 [0, 16] vs. IMT = 123 [101, 180], p <.001). Baseline comorbidity‐adjusted changes over 12 months did not differ between groups in %mBMI (FBT = 12.6 ± 11.9 vs. IMT = 13.7 ± 9.1; p =.702) and EDE‐Q global score (median, [IQR]; FBT = −1.2 [−2.3, 0.2] vs. IMT = −1.3 [−2.8, −0.4]; p =.733). Discussion: Implementing FBT in this pilot study was feasible, acceptable, and safe for youth eligible for IMT according to German S3 guidelines. Non‐inferiority of FBT versus IMT requires confirmation in a sufficiently large multicenter RCT. Public Significance: This pilot study with 62 adolescent patients with anorexia nervosa demonstrated that for 2/3rd of patients eligible for a long hospitalization in the German health care system, outpatient, Family‐based treatment (FBT) was a safe and feasible treatment alternative. Over 12 months, FBT lead to similar weight gain and reduction in eating disorder cognitions as inpatient treatment with fewer hospital days. This pilot study needs to be followed up by a larger, multicenter trial. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Comparing family‐based treatment with inpatient treatment in youth with anorexia nervosa eligible for hospitalization: A 12‐month feasibility study.
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  Data: Objective: Family‐based treatment (FBT) for youth with anorexia nervosa (AN), has not been compared to inpatient, multimodal treatment (IMT). Method: Prospective, non‐randomized pilot feasibility study of adolescents with AN receiving FBT (n = 31), and as a reference point for exploratory outcome comparisons IMT (n = 31), matched for baseline age and percent median BMI (%mBMI). Feasibility of FBT in youth fulfilling criteria for IMT was assessed via study recruitment and retention rates; acceptability via drop‐out and caregiver strain; safety via adverse events; preliminary treatment effectiveness between groups was assessed via a change in %mBMI, AN psychopathology (Eating Disorder Examination‐Questionnaire, EDE‐Q), and hospital days, over 12 months with intent‐to‐treat, mixed models repeated measures analyses covering post‐intervention usual care until 12 months. Results: Taking into account that 8 FBT patients (25.8%) crossed over to IMT due to lack of weight gain or psychiatric concerns, FBT and IMT were similarly feasible, acceptable, and safe, apart from more physical antagonism toward others in FBT (p =.010). FBT lasted longer (median [interquartile range, IQR]; 33.6 [17.4, 49.9] vs. 17.3 [14.4, 24] weeks, p &lt;.001), but required fewer hospital days than IMT (median, [IQR], FBT = 1 [0, 16] vs. IMT = 123 [101, 180], p &lt;.001). Baseline comorbidity‐adjusted changes over 12 months did not differ between groups in %mBMI (FBT = 12.6 &#177; 11.9 vs. IMT = 13.7 &#177; 9.1; p =.702) and EDE‐Q global score (median, [IQR]; FBT = −1.2 [−2.3, 0.2] vs. IMT = −1.3 [−2.8, −0.4]; p =.733). Discussion: Implementing FBT in this pilot study was feasible, acceptable, and safe for youth eligible for IMT according to German S3 guidelines. Non‐inferiority of FBT versus IMT requires confirmation in a sufficiently large multicenter RCT. Public Significance: This pilot study with 62 adolescent patients with anorexia nervosa demonstrated that for 2/3rd of patients eligible for a long hospitalization in the German health care system, outpatient, Family‐based treatment (FBT) was a safe and feasible treatment alternative. Over 12 months, FBT lead to similar weight gain and reduction in eating disorder cognitions as inpatient treatment with fewer hospital days. This pilot study needs to be followed up by a larger, multicenter trial. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=175365515
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  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1002/eat.24098
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 388
    Subjects:
      – SubjectFull: Anorexia nervosa treatment
        Type: general
      – SubjectFull: Family psychotherapy
        Type: general
      – SubjectFull: Pilot projects
        Type: general
      – SubjectFull: Length of stay in hospitals
        Type: general
      – SubjectFull: Professional practice
        Type: general
      – SubjectFull: Suicide
        Type: general
      – SubjectFull: Clinical trials
        Type: general
      – SubjectFull: Burden of care
        Type: general
      – SubjectFull: Evidence-based medicine
        Type: general
      – SubjectFull: Mann Whitney U Test
        Type: general
      – SubjectFull: Fisher exact test
        Type: general
      – SubjectFull: Treatment effectiveness
        Type: general
      – SubjectFull: Comparative studies
        Type: general
      – SubjectFull: Weight gain
        Type: general
      – SubjectFull: T-test (Statistics)
        Type: general
      – SubjectFull: Psychological tests
        Type: general
      – SubjectFull: Hospital care
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Pathological psychology
        Type: general
      – SubjectFull: Questionnaires
        Type: general
      – SubjectFull: Repeated measures design
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Cost effectiveness
        Type: general
      – SubjectFull: Body mass index
        Type: general
      – SubjectFull: Adverse health care events
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Statistical models
        Type: general
      – SubjectFull: Outpatient services in hospitals
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Self-mutilation
        Type: general
      – SubjectFull: Adolescence
        Type: general
      – SubjectFull: Germany
        Type: general
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      – TitleFull: Comparing family‐based treatment with inpatient treatment in youth with anorexia nervosa eligible for hospitalization: A 12‐month feasibility study.
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              M: 02
              Text: Feb2024
              Type: published
              Y: 2024
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