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Ellis A, Gillespie K, McCosker L, Hudson C, Diamond G, Machingura T, Branjerdporn G, Woerwag-Mehta S. Meal support intervention for eating disorders: a mixed-methods systematic review. J Eat Disord 2024; 12:47. [PMID: 38644490 PMCID: PMC11034063 DOI: 10.1186/s40337-024-01002-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/03/2024] [Indexed: 04/23/2024] Open
Abstract
OBJECTIVE Mealtimes are a period of heightened distress for individuals with eating disorders. Patients frequently display maladaptive coping strategies, such as hiding food and using distraction techniques to avoid eating. The aim of this systematic review is to evaluate the evidence for meal support interventions as a first-line intervention for eating disorders. METHOD Six databases were systematically searched in January 2024. Papers including patients with an eating disorder, and meal support or meal supervision, were examined. Quality appraisal was conducted. RESULTS Ten studies met inclusion criteria. Meal support was conducted individually and in group settings. Two studies examined the practical or interpersonal processes of meal support. Carers and trained clinicians implemented meal support. Individuals across the lifespan were examined. Settings included inpatient units, community clinics, and the home. Studies were heterogeneously evaluated with retrospective chart audits, pre- and post- cohort studies, semi-structured interviews, video analysis, and surveys. DISCUSSION Meal support intervention is potentially suitable and beneficial for patients of various age groups and eating disorder diagnoses. Due to the lack of consistent approaches, it is apparent there is no standardised framework and manualised approach. This highlights the need for the development of a co-designed approach, adequate training, and rigorous evaluation.
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Affiliation(s)
- Aleshia Ellis
- Gold Coast Hospital and Health Services, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | - Kerri Gillespie
- Gold Coast Hospital and Health Services, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | - Laura McCosker
- Gold Coast Hospital and Health Services, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | - Carly Hudson
- Bond University, 14 University Drive, Robina, QLD, 4226, Australia
| | - Gideon Diamond
- Gold Coast Hospital and Health Services, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | | | - Grace Branjerdporn
- Gold Coast Hospital and Health Services, 1 Hospital Boulevard, Southport, QLD, 4215, Australia.
- Bond University, 14 University Drive, Robina, QLD, 4226, Australia.
| | - Sabine Woerwag-Mehta
- Gold Coast Hospital and Health Services, 1 Hospital Boulevard, Southport, QLD, 4215, Australia.
- Bond University, 14 University Drive, Robina, QLD, 4226, Australia.
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Eapen V, Gerstl B, Ahinkorah BO, John JR, Hawker P, Nguyen TP, Brice F, Winata T, Bowden M. Evidence-based brief interventions targeting acute mental health presentations for children and adolescents: systematic review. BJPsych Open 2024; 10:e78. [PMID: 38602192 PMCID: PMC11060074 DOI: 10.1192/bjo.2024.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/29/2024] [Accepted: 02/04/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Brief intervention services provide rapid, mobile and flexible short-term delivery of interventions to resolve mental health crises. These interventions may provide an alternative pathway to the emergency department or in-patient psychiatric services for children and young people (CYP), presenting with an acute mental health condition. AIMS To synthesise evidence on the effectiveness of brief interventions in improving mental health outcomes for CYP (0-17 years) presenting with an acute mental health condition. METHOD A systematic literature search was conducted, and the studies' methodological quality was assessed. Five databases were searched for peer-reviewed articles between January 2000 and September 2022. RESULTS We synthesised 30 articles on the effectiveness of brief interventions in the form of (a) crisis intervention, (b) integrated services, (c) group therapies, (d) individualised therapy, (e) parent-child dyadic therapy, (f) general services, (g) pharmacotherapy, (h) assessment services, (i) safety and risk planning and (j) in-hospital treatment, to improve outcomes for CYP with an acute mental health condition. Among included studies, one study was rated as providing a high level of evidence based on the National Health and Medical Research Council levels of evidence hierarchy scale, which was a crisis intervention showing a reduction in length of stay and return emergency department visits. Other studies, of moderate-quality evidence, described multimodal brief interventions that suggested beneficial effects. CONCLUSIONS This review provides evidence to substantiate the benefits of brief interventions, in different settings, to reduce the burden of in-patient hospital and readmission rates to the emergency department.
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Affiliation(s)
- Valsamma Eapen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Brigitte Gerstl
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Bright Opoku Ahinkorah
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and School of Public Health, University of Technology Sydney, Australia
| | - James Rufus John
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; and Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Patrick Hawker
- Discipline of Psychiatry and Mental Health, University of New South Wales, Australia
| | - Thomas P. Nguyen
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Mental Health Team, School of Medicine, Western Sydney University, Australia
| | - Febe Brice
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia
| | - Teresa Winata
- Academic Unit of Infant, Child, and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District and Ingham Institute, Australia; Discipline of Psychiatry and Mental Health, University of New South Wales, Australia; and Infant, Child and Adolescent Mental Health Service (ICAMHS), South Western Sydney Local Health District, Australia
| | - Michael Bowden
- Child and Youth Mental Health, New South Wales Ministry of Health, Australia; Sydney Medical School, University of Sydney, Australia; and Department of Psychological Medicine, Sydney Children's Hospitals Network, Australia
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Meneguzzo P, Baron E, Marchesin S, Andretta AM, Nalesso L, Stella S, Todisco P. Tuning in to recovery: influence of music on emotional well-being during mealtime in inpatient facilities for eating disorders. J Eat Disord 2024; 12:7. [PMID: 38225626 PMCID: PMC10789025 DOI: 10.1186/s40337-024-00970-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/11/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND In rehabilitating eating disorders (ED), mealtimes are critical but often induce stress, both for restrictive and binge-purge disorders. Although preliminary data indicate a positive effect of music during mealtime, few studies employ an experimental approach. This study examines the influence of background music during mealtime in an inpatient ward setting, offering a real-world perspective. METHODS Fifty-one women diagnosed with ED participated in this within-subjects study. Over two weeks, during lunch and dinner, they were exposed to three randomized music conditions: no music, focus piano music, and pop music. The self-report questionnaires captured affective states, noise levels, and hunger, while trained dietitians recorded food consumption and eating rituals. RESULTS The absence of music led to an increase in uneaten food (p = 0.001) and the presence of eating rituals (p = 0.012) during mealtimes. Significantly, only silence during mealtime reduced positive emotional states, while background music maintained positive emotions (p < 0.001). No specific differences emerged between the two types of music (focus piano and pop). CONCLUSIONS These findings affirm the positive impact of background music during mealtime in real-world settings, enhancing the potential of inpatient eating rehabilitation programs for individuals with ED. More studies are needed to validate and extend these results, particularly in outpatient settings.
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Affiliation(s)
- Paolo Meneguzzo
- Department of Neuroscience, University of Padova, 35128, Padua, Italy.
- Padova Neuroscience Center, University of Padova, Padua, Italy.
| | - Elisa Baron
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Silvia Marchesin
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Anna Maria Andretta
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Lisa Nalesso
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Sonia Stella
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
| | - Patrizia Todisco
- Eating Disorders Unit, Villa Margherita - Neomesia, Arcugnano, Vicenza, Italy
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Otis M, Barber S, Amet M, Nicholls D. Models of integrated care for young people experiencing medical emergencies related to mental illness: a realist systematic review. Eur Child Adolesc Psychiatry 2023; 32:2439-2452. [PMID: 36151355 PMCID: PMC9510153 DOI: 10.1007/s00787-022-02085-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
Mental illness heightens risk of medical emergencies, emergency hospitalisation, and readmissions. Innovations for integrated medical-psychiatric care within paediatric emergency settings may help adolescents with acute mental disorders to get well quicker and stay well enough to remain out of hospital. We assessed models of integrated acute care for adolescents experiencing medical emergencies related to mental illness (MHR). We conducted a systematic review by searching MEDLINE, PsychINFO, Embase, and Web of Science for quantitative studies within paediatric emergency medicine, internationally. We included populations aged 8-25 years. Our outcomes were length of hospital stay (LOS), emergency hospital admissions, and rehospitalisation. Limits were imposed on dates: 1990 to June 2021. We present a narrative synthesis. This study is registered on PROSPERO: 254,359. 1667 studies were screened, 22 met eligibility, comprising 39,346 patients. Emergency triage innovations reduced admissions between 4 and 16%, including multidisciplinary staffing and training for psychiatric assessment (F(3,42) = 4.6, P < 0.05, N = 682), and telepsychiatry consultations (aOR = 0.41, 95% CI 0.28-0.58; P < 0.001, N = 597). Psychological therapies delivered in emergency departments reduced admissions 8-40%, including psychoeducation (aOR = 0.35, 95% CI 0.17-0.71, P < 0.01, N = 212), risk-reduction counselling for suicide prevention (OR = 2.78, 95% CI 0.55-14.10, N = 348), and telephone follow-up (OR = 0.45, 95% CI 0.33-0.60, P < 0.001, N = 980). Innovations on acute wards reduced readmissions, including guided meal supervision for eating disorders (P = 0.27), therapeutic skills for anxiety disorders, and a dedicated psychiatric crisis unit (22.2 vs 8.5% (P = 0.008). Integrated pathway innovations reduced readmissions between 8 and 37% including family-based therapy (FBT) for eating disorders (X2(1,326) = 8.40, P = 0.004, N = 326), and risk-targeted telephone follow-up or outpatients for all mental disorders (29.5 vs. 5%, P = 0.03, N = 1316). Studies occurred in the USA, Canada, or Australia. Integrated care pathways to psychiatric consultations, psychological therapies, and multidisciplinary follow-up within emergency paediatric services prevented lengthy and repeat hospitalisation for MHR emergencies. Only six of 22 studies adjusted for illness severity and clinical history between before- and after-intervention cohorts and only one reported socio-demographic intervention effects.
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Affiliation(s)
- Michaela Otis
- Imperial College London, South Kensington, London, SW7 2BX UK
- NIHR Applied Research Collaboration (ARC) Northwest London, London, UK
- Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Susan Barber
- Imperial College London, South Kensington, London, SW7 2BX UK
- NIHR Applied Research Collaboration (ARC) Northwest London, London, UK
- Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Mona Amet
- Imperial College London, South Kensington, London, SW7 2BX UK
| | - Dasha Nicholls
- Imperial College London, South Kensington, London, SW7 2BX UK
- NIHR Applied Research Collaboration (ARC) Northwest London, London, UK
- Chelsea and Westminster NHS Foundation Trust, London, UK
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Lacalaprice D, Mocini E, Frigerio F, Minnetti M, Piciocchi C, Donini LM, Poggiogalle E. Effects of mealtime assistance in the nutritional rehabilitation of eating disorders. Eat Weight Disord 2023; 28:73. [PMID: 37688675 PMCID: PMC10492868 DOI: 10.1007/s40519-023-01605-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 08/29/2023] [Indexed: 09/11/2023] Open
Abstract
PURPOSE The aim of the study was to examine the effects of meal supervision, provided by health professionals, volunteers or family members, on anthropometric, nutritional, psychological, and behavioural outcomes in patients with eating disorders (EDs). METHODS The present systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The last search was conducted in three databases (PubMed, Scopus, and the Cochrane library). Inclusion criteria considered paediatric and adult patients suffering from EDs, regardless of ethnicity, and treated in different therapeutic settings. The quality of the studies was evaluated using the Newcastle Ottawa Scale (NOS) adapted for cross-sectional studies and Version 2 of the Cochrane risk-of-bias assessment tool for randomised trials. RESULTS 3282 articles were retrieved, out of which only 6 met the eligibility criteria. A marked heterogeneity in definitions and approaches to supervised mealtime was observed. This variability emerged in the methodologies used in the supervised meal, and in the reference values for the outcome measures that were used, such as the analysis of different parameters. Based on these observations, mealtime assistance provided to patients with EDs shows an overall positive effect on eating behaviour and dysfunctional attitudes. Future research should be prompted to provide a thorough definition of a structured procedure for meal assistance to be potentially and systematically included in the nutritional rehabilitation protocols for patients with EDs. LEVEL OF EVIDENCE Level IV systematic reviews of uncontrolled trials.
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Affiliation(s)
- Doriana Lacalaprice
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Edoardo Mocini
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
| | - Francesco Frigerio
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Marianna Minnetti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Claudia Piciocchi
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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Ceccato E, Roveran C. Effects of Music Therapy in the Reduction of Pre-Meal Anxiety in Patients Suffering from Anorexia Nervosa. Brain Sci 2022; 12:brainsci12060801. [PMID: 35741686 PMCID: PMC9221392 DOI: 10.3390/brainsci12060801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Literature reviews appear to indicate that Music Therapy (MT) may instil a sense of empowerment and generate feelings of renewed self-confidence, distracting subjects who follow this type of intervention from negative thoughts and, generally, helping patients suffering from Anorexia Nervosa (AN) to redevelop or rediscover their identity. The purpose of the study reported in this paper is to investigate whether MT proposed before an evening meal is capable of decreasing pre-meal anxiety in adolescents suffering from AN who follow the Day-hospital Treatment Programme at the San Bortolo Hospital of Vicenza (Italy). A total of 24 patients participated voluntarily in once-weekly sessions of group-based MT conducted by a qualified music therapist over a period of six months. Before evening meals on Monday, Tuesday and Wednesday, pre-meal anxiety was measured using a self-report scale, and the MT group session occurred every Wednesday before the evening meal was consumed. MT activities were both active and receptive. It has been found that with respect to Mondays and Tuesdays, pre-meal anxiety was significantly lower on Wednesdays following participation in the MT group. MT is evidently capable of reducing pre-meal anxiety and may be adopted as a supportive element in treatment plans relating to patients with AN in a day-hospital treatment programme.
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Affiliation(s)
- Enrico Ceccato
- Department of Mental Health, San Bortolo Hospital, 36100 Vicenza, Italy
- The Giovanni Ferrari Music Therapy School, 35100 Padua, Italy;
- Correspondence:
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Isserlin L, Spettigue W, Norris M, Couturier J. Outcomes of inpatient psychological treatments for children and adolescents with eating disorders at time of discharge: a systematic review. J Eat Disord 2020; 8:32. [PMID: 32637099 PMCID: PMC7333407 DOI: 10.1186/s40337-020-00307-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 05/28/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Recommended first line treatment for children and adolescent eating disorders is outpatient therapy. However, a significant number of children and adolescents with eating disorders continue to require inpatient treatment during the course of their illness. The effect of psychological treatments in an inpatient setting on outcomes at the time of discharge remains unclear. This paper presents the results of a review of the literature on outcomes at the time of discharge following inpatient psychological treatment for children and adolescents with eating disorders. MAIN BODY The majority of studies found were observational and of low quality. The most consistently reported positive outcome of inpatient treatment is weight gain. Results related to symptom change and motivation vary between studies. Within the inpatient setting, there is considerable heterogeneity in the types of treatments offered, goals of treatment, length of stay and outcomes measured. CONCLUSION There remains a paucity of high-quality studies examining the effect of psychological treatments provided to children and adolescents in an inpatient setting. The significant heterogeneity between studies makes it not possible to compare across studies. Future research should aim to resolve these deficiencies in order to better determine the specific factors that contribute to positive outcomes of inpatient treatment for children and adolescents with eating disorders.
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Affiliation(s)
- Leanna Isserlin
- Department of Psychiatry, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1 Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1 Canada
| | - Wendy Spettigue
- Department of Psychiatry, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1 Canada.,Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1 Canada
| | - Mark Norris
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1 Canada.,Division of Adolescent Health, Department of Pediatrics, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON K1H 8L1 Canada
| | - Jennifer Couturier
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON L8N3Z5 Canada
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Couturier J, Isserlin L, Norris M, Spettigue W, Brouwers M, Kimber M, McVey G, Webb C, Findlay S, Bhatnagar N, Snelgrove N, Ritsma A, Preskow W, Miller C, Coelho J, Boachie A, Steinegger C, Loewen R, Loewen T, Waite E, Ford C, Bourret K, Gusella J, Geller J, LaFrance A, LeClerc A, Scarborough J, Grewal S, Jericho M, Dimitropoulos G, Pilon D. Canadian practice guidelines for the treatment of children and adolescents with eating disorders. J Eat Disord 2020; 8:4. [PMID: 32021688 PMCID: PMC6995106 DOI: 10.1186/s40337-020-0277-8] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 01/06/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Eating disorders are common and serious conditions affecting up to 4% of the population. The mortality rate is high. Despite the seriousness and prevalence of eating disorders in children and adolescents, no Canadian practice guidelines exist to facilitate treatment decisions. This leaves clinicians without any guidance as to which treatment they should use. Our objective was to produce such a guideline. METHODS Using systematic review, the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system, and the assembly of a panel of diverse stakeholders from across the country, we developed high quality treatment guidelines that are focused on interventions for children and adolescents with eating disorders. RESULTS Strong recommendations were supported specifically in favour of Family-Based Treatment, and more generally in terms of least intensive treatment environment. Weak recommendations in favour of Multi-Family Therapy, Cognitive Behavioural Therapy, Adolescent Focused Psychotherapy, adjunctive Yoga and atypical antipsychotics were confirmed. CONCLUSIONS Several gaps for future work were identified including enhanced research efforts on new primary and adjunctive treatments in order to address severe eating disorders and complex co-morbidities.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Wendy Preskow
- National Initiative for Eating Disorders, Toronto, Canada
| | - Catherine Miller
- Canadian Mental Health Association - Waterloo, Wellington, Dufferin, Kitchener, Canada
| | | | | | | | | | | | | | - Catherine Ford
- 9Ontario Ministry of Health and Long-Term Care, Toronto, Canada
| | - Kerry Bourret
- 10St. Joseph's Care Group - Thunder Bay, Thunder Bay, Canada
| | | | - Josie Geller
- 6The Univeristy of British Columbia, Vancouver, Canada
| | | | | | - Jennifer Scarborough
- Canadian Mental Health Association - Waterloo, Wellington, Dufferin, Kitchener, Canada
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Shadman KA, Coller RJ, Smith W, Kelly MM, Cody P, Taft W, Bodine L, Sklansky DJ. Managing Eating Disorders on a General Pediatrics Unit: A Centralized Video Monitoring Pilot. J Hosp Med 2019; 14:357-360. [PMID: 30986188 PMCID: PMC6625438 DOI: 10.12788/jhm.3176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Adolescents with severe eating disorders require hospitalization for medical stabilization. Supervision best practices for these patients are not established. This study sought to evaluate the cost and feasibility of centralized video monitoring (CVM) supervision on a general pediatric unit of an academic quaternary care center. This was a retrospective cohort study of nursing assistant (NA) versus CVM supervision for girls 12-18 years old admitted for medical stabilization of an eating disorder between September 2013 and March 2017. There were 37 consecutive admissions (NA = 23 and CVM = 14). NA median supervision cost was more expensive than CVM ($4,104/admission vs $1,166/admission, P < .001). Length of stay and days to weight gain were not statistically different. There were no occurances of family refusal of CVM, conversion from CVM to NA, technological failure, or unplanned discontinuation. Video monitoring was feasible and associated with lower supervision costs than one-to-one NA supervision. Larger samples in multiple centers are needed to confirm the safety, acceptability, and efficacy of CVM.
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Affiliation(s)
- Kristin A Shadman
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Corresponding Author: Kristin A Shadman, MD; E-mail: ; Telephone: 608-265-8561
| | - Ryan J Coller
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Windy Smith
- American Family Children’s Hospital, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | - Michelle M Kelly
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Paula Cody
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - William Taft
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Laura Bodine
- American Family Children’s Hospital, University of Wisconsin Hospital and Clinics, Madison, Wisconsin
| | - Daniel J Sklansky
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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