scholarly journals Two-year Follow-up of a Pragmatic Randomised Controlled Trial Examining the Effect of Adding a Carer's Skill Training Intervention in Inpatients with Anorexia Nervosa

2015 ◽  
Vol 24 (2) ◽  
pp. 122-130 ◽  
Author(s):  
Nicholas Magill ◽  
Charlotte Rhind ◽  
Rebecca Hibbs ◽  
Elizabeth Goddard ◽  
Pamela Macdonald ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Skill Training ◽  
Training Intervention ◽  
Randomised Controlled ◽  
Pragmatic Randomised Controlled Trial

scholarly journals A randomised controlled trial of three psychological treatments for anorexia nervosa

2017 ◽  
Vol 47 (16) ◽  
pp. 2823-2833 ◽  
Author(s):  
S. Byrne ◽  
T. Wade ◽  
P. Hay ◽  
S. Touyz ◽  
C. G. Fairburn ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Healthy Weight ◽  
Psychological Treatments ◽  
Psychosocial Impairment ◽  
Eating Disorder Psychopathology ◽  
Randomised Controlled

BackgroundThere is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy.MethodA multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25–40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment.ResultsTreatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up.ConclusionThe findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ACTRN 12611000725965) http://www.anzctr.org.au/

scholarly journals Clinical effectiveness of a skills training intervention for caregivers in improving patient and caregiver health following in-patient treatment for severe anorexia nervosa: pragmatic randomised controlled trial

BJPsych Open ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 56-66 ◽  
Author(s):  
Rebecca Hibbs ◽  
Nicholas Magill ◽  
Elizabeth Goddard ◽  
Charlotte Rhind ◽  
Simone Raenker ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Skills Training ◽  
Patient Treatment ◽  
Training Intervention ◽  
Randomised Controlled ◽  
The Impact

BackgroundFamilies express a need for information to support people with severe anorexia nervosa.AimsTo examine the impact of the addition of a skills training intervention for caregivers (Experienced Caregivers Helping Others, ECHO) to standard care.MethodPatients over the age of 12 (mean age 26 years, duration 72 months illness) with a primary diagnosis of anorexia nervosa and their caregivers were recruited from 15 in-patient services in the UK. Families were randomised to ECHO (a book, DVDs and five coaching sessions per caregiver) or treatment as usual. Patient (n=178) and caregiver (n=268) outcomes were measured at discharge and 6 and 12 months after discharge.ResultsPatients with caregivers in the ECHO group had reduced eating disorder psychopathology (EDE-Q) and improved quality of life (WHO-Quol; both effects small) and reduced in-patient bed days (7–12 months post-discharge). Caregivers in the ECHO group had reduced burden (Eating Disorder Symptom Impact Scale, EDSIS), expressed emotion (Family Questionnaire, FQ) and time spent caregiving at 6 months but these effects were diminished at 12 months.ConclusionsSmall but sustained improvements in symptoms and bed use are seen in the intervention group. Moreover, caregivers were less burdened and spent less time providing care. Caregivers had most benefit at 6 months suggesting that booster sessions, perhaps jointly with the patients, may be needed to maintain the effect. Sharing skills and information with caregivers may be an effective way to improve outcomes. This randomised controlled trial (RCT) was registered with Current Controlled Trials ISRCTN06149665.

scholarly journals DIETETIC MANAGEMENT OF MALNUTRITION IN A HEALTHCARE SETTING: A SIX MONTH PRAGMATIC RANDOMISED CONTROLLED TRIAL WITH A 24 MONTH FOLLOW-UP

2016 ◽  
pp. 1-6
Author(s):  
M. Milosavljevic ◽  
S. Bowden ◽  
A. Ferguson ◽  
L. Barone ◽  
S. Mason ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Nutritional Status ◽  
Nutritional Assessment ◽  
Controlled Trial ◽  
Initial Contact ◽  
Current Standard ◽  
Level Of Satisfaction ◽  
Randomised Controlled ◽  
Pragmatic Randomised Controlled Trial

Background: This study explored approaches to long term dietetic management of disease related malnutrition, a growing problem across hospitals in the industrialised world. Objectives: The aim of this study was to compare the effectiveness of two current models of dietetic care for patients with Disease Related Malnutrition. Design: A six month pragmatic randomised controlled trial was conducted with a 24 month follow up. Setting: All patients referred to the dietitian from two general medical and two surgical wards at a major public regional referral centre who met the inclusion criteria were invited to participate. This included being identified on admission as “at risk” of malnutrition or malnourished. Participants: Dietitians attended to 1222 patients during the recruitment period. From 320 eligible participants, 241 (78%) were recruited; of these only 85 (27%) completed the study. Intervention: It compared extended community–based dietetic management with the more traditional short-term hospital care alone. Measurements: A series of variables were recorded at enrolment, six months and then a follow up at 24 months. These included: nutritional assessment, level of satisfaction with the dietetic service, bed day utilisation, readmission and mortality rates. Results: An intention to treat analysis showed both groups had a significant improvement in nutritional status at six months and this was maintained at 24 months. When patients received an extended community care dietetic service they were significantly more satisfied with the dietetic service than those who did not receive the service (P<0.001). Conclusion: The current standard dietetic care of patients admitted to our institution led to significant improvements in their nutritional status at six months and two years from initial contact. The patient’s level of satisfaction with the dietetic service was high when they were seen in the community.

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