Department of Paediatrics, University of Toronto, Toronto, ON, Canada.
Division of Adolescent Medicine, McMaster University, Hamilton, ON, Canada.
Eat Disord. 2020 Jan-Feb;28(1):47-66. doi: 10.1080/10640266.2018.1560853. Epub 2019 Jan 21.
Youth with eating disorders are often cared for by specialized interdisciplinary teams in pediatric tertiary care centers. Enhanced involvement of primary care providers may provide added benefits to patients because it offers improved access, better continuity of care, and possibly less financial burden. This paper aims to synthesize and assess the literature on the role of the primary care provider in treating pediatric eating disorders in order to identify an optimal model of shared care. Sources were identified by entering search terms in 10 databases. Eligible sources were English publications focusing on primary care-based interventions for eating disorders in youth (=<24 years). The search yielded 5,516 unique citations. Of these, 61 were ultimately included. Sources fell into two categories: (1) primary research (n = 3) and (2) reviews with recommendations for primary care providers (n = 58). The primary studies considered the primary care provider conducting behavioral therapy and guided self-help. Review articles suggested providing education, assessing for hospitalization, aiding in weight restoration, managing complications, referring, and coordinating care. Limited evidence exists that can guide effective primary care-based interventions for the treatment of pediatric eating disorders. Further research is needed to develop and evaluate interventions for the treatment of pediatric eating disorders in primary care settings so that best practices can be identified.
患有饮食失调的年轻人通常在儿科三级保健中心由专门的跨学科团队进行治疗。初级保健提供者的更多参与可能会为患者带来额外的好处,因为它提供了更好的就诊机会、更好的护理连续性,并且可能负担更少的经济负担。本文旨在综合评估初级保健提供者在治疗儿科饮食失调方面的作用的文献,以确定共享护理的最佳模式。通过在 10 个数据库中输入搜索词来确定来源。符合条件的来源是关注青年(<=24 岁)饮食失调的基于初级保健的干预措施的英文出版物。该搜索产生了 5516 个独特的引用。其中,最终纳入了 61 个。来源分为两类:(1)原始研究(n=3)和(2)针对初级保健提供者的建议的综述(n=58)。主要研究考虑了由初级保健提供者进行行为治疗和指导自助。综述文章建议提供教育、评估住院治疗、帮助体重恢复、管理并发症、转介和协调护理。现有证据有限,无法指导有效的基于初级保健的儿科饮食失调治疗干预措施。需要进一步研究,以制定和评估初级保健环境中治疗儿科饮食失调的干预措施,以便确定最佳实践。