Franklin Elizabeth V, Mathias Margaret, Nguyen Duc T, Hergenroeder Albert C, Wiemann Constance M
Division of Adolescent Medicine & Sports Medicine, Department of Pediatrics, Baylor College of Medicine & Texas Children's Hospital, 17198 St. Luke's Way, Suite 630, Houston, TX, 77384, USA.
Division of Epidemiology, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
J Eat Disord. 2025 Jun 12;13(1):109. doi: 10.1186/s40337-025-01315-w.
Adolescent patients with Anorexia Nervosa (AN) and Atypical Anorexia Nervosa (AAN) admitted to an inpatient medical unit are at risk of relapse if they do not receive follow up treatment. Yet treatment adherence following discharge remains poor. One possible reason for poor treatment adherence is insufficient support for parents. This pilot study explored the preliminary impact of a novel family navigator (FN) intervention on adolescent patient treatment adherence following inpatient care.
This was a pilot prospective study with a retrospective control cohort. Twenty-three adolescent patients with AN or AAN discharging from an Adolescent Medicine inpatient medical unit whose parents received three months of weekly support from a FN were compared to 23 patients with AN or AAN whose parents did not receive FN support as the FN was not in place (historical control group). The primary outcome measure was medical, nutrition, and mental health appointment attendance (frequency and rate). Secondary outcomes included self-reported mental health changes over 3 months, whether or not the patient was readmitted to the hospital within 6 months of hospital discharge, and parental satisfaction with the program.
Patients in the FN intervention group attended more outpatient appointments overall (medical, nutrition, mental health) compared to the historical control group. The FN intervention was not related to readmission rates or self-reported mental health symptom changes. Parental satisfaction was rated helpful or higher in all categories. There were no differences in appointment attendance or parent satisfaction ratings based on age, gender, race, ethnicity, primary language, or insurance status.
This study provides preliminary support that a FN assisting parents of adolescents with AN or AAN in transitioning from inpatient to outpatient care would improve treatment engagement. Future randomized trials with larger cohorts are needed to best determine how a FN can improve access to care for families, especially for families whose primary language is not English, have public or no insurance, or experience other barriers to care.
入住内科病房的神经性厌食症（AN）和非典型神经性厌食症（AAN）青少年患者若未接受后续治疗，有复发风险。然而出院后的治疗依从性仍然很差。治疗依从性差的一个可能原因是对父母的支持不足。这项试点研究探讨了一种新型家庭导航员（FN）干预措施对青少年患者住院治疗后治疗依从性的初步影响。
这是一项带有回顾性对照队列的试点前瞻性研究。将23名患有AN或AAN且从青少年医学内科病房出院的青少年患者与其父母接受FN每周三个月支持的情况，与23名患有AN或AAN且其父母未获得FN支持（历史对照组，因为当时没有FN）的患者进行比较。主要结局指标是医疗、营养和心理健康预约就诊情况（频率和比率）。次要结局包括3个月内自我报告的心理健康变化、患者在出院后6个月内是否再次入院以及父母对该项目的满意度。
与历史对照组相比，FN干预组的患者总体上参加了更多的门诊预约（医疗、营养、心理健康）。FN干预与再入院率或自我报告的心理健康症状变化无关。父母满意度在所有类别中都被评为有帮助或更高。在预约就诊情况或父母满意度评分方面，基于年龄、性别、种族、民族、主要语言或保险状况没有差异。
本研究提供了初步支持，即FN协助患有AN或AAN的青少年父母从住院治疗过渡到门诊治疗将提高治疗参与度。未来需要进行更大样本量的随机试验，以最好地确定FN如何改善家庭获得医疗服务的机会，特别是对于主要语言不是英语、有公共保险或无保险或经历其他医疗障碍的家庭。
