Hambleton A, Le Grange D, Miskovic-Wheatley J, Touyz S, Cunich M, Maguire S
InsideOut Institute for Eating Disorders, The Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, Australia.
UCSF Weill Institute for Neurosciences, School of Medicine, University of California, San Francisco, San Francisco, California USA.
J Eat Disord. 2020 Oct 9;8:50. doi: 10.1186/s40337-020-00328-x. eCollection 2020.
Family-based treatment (FBT) is an efficacious outpatient intervention for young people diagnosed with Anorexia Nervosa (AN). To date, treatment to protocol has relied on standard face-to-face delivery. Face-to-face therapy is subject to geographic, temporal and human factors, rendering it particularly susceptible to inequities and disruption. This has resulted in poorer service provision for rural and regional families, and recently a significant challenge to providing face-to-face services during the COVID-19 global pandemic. The present study examines whether FBT for AN can be successfully translated to a digital delivery platform to address these access issues.
Forty young people aged 12 to 18 years who meet DSM-5 diagnostic criteria for AN, and live in a rural or regional setting, will along with their family be recruited to the study. Trained therapists will provide 18 sessions of FBT over 9 months via telemedicine to the home of the young person and their family. The analysis will examine treatment effectiveness, feasibility, acceptability, and cost-effectiveness.
The study addresses the treatment needs of families not able to attend face-to-face clinical services for evidence-based treatment for eating disorders. This might be due to several barriers, including a lack of local services or long travel distances to services. There has been a recent and unprecedented demand for telemedicine to facilitate the continuity of care during COVID-19 despite geographical circumstances. If delivering treatment in this modality is clinically and economically effective and feasible, it will facilitate access to potentially lifesaving, evidence-based treatments for families formerly unable to access such care and provide evidence for the continuity of services when and where face-to-face treatment is not feasible.
基于家庭的治疗(FBT)是一种针对被诊断患有神经性厌食症(AN)的年轻人的有效门诊干预措施。迄今为止,按照治疗方案进行的治疗一直依赖于标准的面对面服务。面对面治疗受到地理、时间和人为因素的影响,使其特别容易出现不公平和中断的情况。这导致农村和偏远地区家庭获得的服务较差,最近在2019冠状病毒病全球大流行期间提供面对面服务也面临重大挑战。本研究探讨针对神经性厌食症的基于家庭的治疗能否成功转化为数字服务平台,以解决这些服务可及性问题。
将招募40名年龄在12至18岁之间、符合DSM-5神经性厌食症诊断标准且生活在农村或偏远地区的年轻人及其家人参与该研究。经过培训的治疗师将通过远程医疗在9个月内为年轻人及其家人提供18次基于家庭的治疗课程。分析将考察治疗效果、可行性、可接受性和成本效益。
该研究满足了那些无法参加面对面临床服务以接受饮食失调循证治疗的家庭的治疗需求。这可能是由于多种障碍,包括缺乏当地服务或前往服务机构的路途遥远。尽管存在地理因素,但最近对远程医疗的需求空前高涨,以促进在2019冠状病毒病期间的持续护理。如果以这种方式提供治疗在临床和经济上是有效且可行的,它将有助于为以前无法获得此类护理的家庭提供可能救命的循证治疗,并为在面对面治疗不可行时和地点的服务连续性提供证据。