Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA.
Eur Eat Disord Rev. 2020 Nov;28(6):789-795. doi: 10.1002/erv.2785. Epub 2020 Aug 26.
Access to evidence-based treatment for eating disorders is severely limited by patient barriers and available clinician training. While clinical parameters often point to the need for a high level of care, patients may resist pursuing higher levels of care due to these barriers. One option that might mitigate such obstacles is the provision of a higher level of care via internet-based treatment for eating disorders. We sought to determine the feasibility, acceptability, and preliminary clinical outcomes associated with treatment of eating disorders through virtual intensive outpatient programming (VIOP). Fifty-seven patients meeting DSM-5 criteria for an eating disorder participated in VIOP. Of the 57 patients in VIOP treatment, 3 did not complete voluntary measures at admission or discharge, and 9 additional patients did not complete voluntary measures at discharge. Overall, 45 VIOP patients completed admission and discharge assessments, including a net promoter score (NPS) question assessing patient acceptability. Recruitment, treatment adherence, and completion of assessments in VIOP were feasible and acceptable. VIOP patients showed significant and clinically meaningful improvements in all outcomes measured, including self-reported eating disorder symptoms, depression, self-esteem, quality of life, and overall satisfaction. VIOP appears feasible, acceptable, and evidences clinically meaningful changes in eating and mood disorder symptoms.
获得基于证据的饮食障碍治疗方法受到患者障碍和可用临床医生培训的严重限制。尽管临床参数经常指出需要高水平的护理，但由于这些障碍，患者可能会抵制寻求更高水平的护理。一种可能减轻这些障碍的选择是通过基于互联网的饮食障碍治疗提供更高水平的护理。我们试图通过虚拟强化门诊计划（VIOP）确定与饮食障碍治疗相关的可行性、可接受性和初步临床结果。57 名符合 DSM-5 饮食障碍标准的患者参加了 VIOP。在 VIOP 治疗的 57 名患者中，有 3 名在入院或出院时未完成自愿措施，还有 9 名额外患者在出院时未完成自愿措施。总体而言，45 名 VIOP 患者完成了入院和出院评估，包括评估患者可接受性的净推荐值（NPS）问题。VIOP 的招募、治疗依从性和评估完成情况是可行且可接受的。VIOP 患者在所有测量的结果中均显示出显著且具有临床意义的改善，包括自我报告的饮食障碍症状、抑郁、自尊、生活质量和总体满意度。VIOP 似乎是可行的、可接受的，并在饮食和情绪障碍症状方面具有临床意义的变化。
