Setting standards of care for diagnosis and treatment of adolescents with eating disorders

Anorexia nervosa: the cost of long-term disability

This study was performed to estimate the cost of long-term disability in people who have anorexia nervosa (AN) that live in the province of British Columbia (BC), Canada. Canada provides universal socialized health and welfare services, and each of the 10 provinces is responsible for its own funding. As the provincial government of BC does not categorize its disability payments by the cause of the disability, a survey was used to determine the rate of disability from AN. A sensitivity analysis was performed to assess the influence of variations on the yearly cost of disability in BC: the number of patients with AN was varied between 1.0 and 2.0% of the female and 0.05 and 0.1% of the male population; the percentage of patients with AN receiving disability payments was determined by the survey to be 35%; the cost of these payments was varied between the lowest and highest benefits a single person can receive from the BC provincial government; and finally, to allow for possible sampling bias and a possible lower prevalence of AN, the lower limit of the sensitivity analysis was derived by dividing the lowest estimate above by seven. The sensitivity analysis revealed that the total estimated cost of long-term disability in BC could be as low as $2.5 million (Canadian) or as high as $101.7 million per year, which is a cost of up to 30 times the total yearly cost of all tertiary care services for the treatment of eating disorders in BC. In view of this finding, an increase in funding is warranted for primary, secondary and tertiary prevention programs for AN in BC.

Bulimia nervosa: knowledge, awareness, and skill levels among advanced practice nurses

PURPOSE

To examine the knowledge, awareness, and self-perceived skill levels regarding bulimia nervosa (BN) among advance practice nurses (APNs) caring for young female patients.

DATA SOURCES

Two hundred APNs of various nurse practitioner (NP) specialties were surveyed with a mailed questionnaire. One hundred and twenty-one (61%) surveys were returned and analyzed.

CONCLUSIONS

Results demonstrated that APNs are knowledgeable and aware about BN. There were several statistically significant relationships among awareness and self-perceived skill levels. Pediatric NPs were found to be the most aware of BN in their young female patients.

IMPLICATIONS FOR PRACTICE

The incidence of eating disorders is on the rise. Bulimia nervosa, a common secretive illness, poses a significant challenge for APNs potentially leading to missed diagnosis. There is a paucity of research exploring this issue. Study findings provide evidence to enhance curricula on eating disorders in academic and continuing education programs and guidance for future research.