Eating Disorder Service, South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK.
Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Early Interv Psychiatry. 2020 Oct;14(5):625-630. doi: 10.1111/eip.12941. Epub 2020 Feb 16.
Eating disorders are serious psychiatric disorders with high rates of morbidity and mortality. Early intervention can improve treatment outcomes and reduce disruption to psychosocial development. However, early intervention is not well established in the eating disorder field. First episode rapid early intervention for eating disorders (FREED) was developed to address barriers to early, effective eating disorder treatment in emerging adults aged 16 to 25 years. Since 2014, FREED has progressed from a single-site research project to an evidence-based care approach in nine eating disorder services. This paper aims to summarize key learning from the scaling of FREED to date, with attention to how this learning may generalizes to other models of care.
We describe the development, scaling and implementation of FREED with reference to the RE-AIM (reach; effectiveness/efficacy; adoption; implementation; maintenance) framework. We also summarize challenges and learning in each of the RE-AIM domains.
FREED has demonstrated real-world validity across diverse clinical contexts, geographical regions and populations. Key outcomes are seen for each of the RE-AIM domains.
FREED provides an example of effective, non-commercial scaling of an early intervention eating disorder care pathway. This work is likely to be particularly relevant to others looking to scale-up early intervention models and for those working in secondary and tertiary mental health settings.
饮食失调是一种严重的精神疾病，发病率和死亡率都很高。早期干预可以改善治疗效果，减少对心理社会发展的干扰。然而，饮食失调领域的早期干预措施并不完善。首发快速早期干预饮食失调症（FREED）旨在解决 16 至 25 岁的年轻成年人中早期有效饮食失调治疗的障碍。自 2014 年以来，FREED 已从一个单一地点的研究项目发展为九个饮食失调服务机构的循证护理方法。本文旨在总结迄今为止 FREED 扩展的主要经验教训，并关注这些经验教训如何推广到其他护理模式。
我们参考 RE-AIM（覆盖范围；有效性/功效；采用；实施；维护）框架描述了 FREED 的开发、扩展和实施。我们还总结了每个 RE-AIM 领域的挑战和学习。
FREED 在不同的临床环境、地理区域和人群中都表现出了现实世界的有效性。每个 RE-AIM 领域都可以看到关键结果。
FREED 为早期干预饮食失调护理途径的有效、非商业化扩展提供了一个范例。这项工作可能对其他希望扩大早期干预模型的人以及在二级和三级精神卫生机构工作的人特别相关。
