Improving aftercare with technology for anorexia nervosa after intensive inpatient treatment: A pilot randomized controlled trial with a therapist-guided smartphone app
Improving aftercare with technology for anorexia nervosa after intensive inpatient treatment: A pilot randomized controlled trial with a therapist-guided smartphone app
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DOI：
10.1002/eat.23152
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发表时间：
2019-08-20
影响因子：
5.5
通讯作者：
Schlegl, Sandra
中科院分区：
文献类型：
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作者：
Neumayr, Christina;Voderholzer, Ulrich;Schlegl, Sandra
目的 评估严重神经性厌食症 (AN) 患者住院治疗后采用创新治疗师引导的智能手机善后干预措施的可行性、可接受性和初步疗效。方法 40 名 AN 女性患者 (ICD-10: F50.0/F50.1)（年龄：15-36 岁）被随机分配接受为期 8 周的基于智能手机的术后护理干预（德国版“康复记录”），并以治疗师反馈作为常规治疗的辅助手段（干预组 [IG]），或单独接受常规治疗（对照组 [CG]）。在出院时（基线）、干预后（8周后）和6个月随访时评估体重指数（BMI）和饮食失调（ED）症状。此外，还评估了患者的满意度、对基于智能手机的干预的依从性以及出院后医疗保健的利用。结果 患者表现出高度的依从性，并对应用程序和善后干预的接受度非常高。我们发现，干预后，在 BMI（d = -0.24；95% 置信区间 [CI] [-0.90, 0.41]）和 ED 症状（全球饮食失调检查问卷：d = 0.56；95% CI [-0.10, 1.22]）方面，有利于 IG 的不显着的小到中等组间效应大小。在 6 个月的随访中，效果逐渐消失，IG 和 CG 之间没有明显的差异。讨论 这是第一项针对 AN 出院住院患者评估治疗师指导的基于智能手机的术后护理干预的研究。结果表明，这种干预措施得到了患者的高度接受，并且作为常规治疗的附加疗法，它可以支持症状稳定或持续改善。现在计划进行更大规模的随机对照试验，以进一步评估这种术后护理干预措施对 AN 患者的疗效。
Objective To evaluate the feasibility, acceptability, and preliminary efficacy of an innovative therapist-guided smartphone-based aftercare intervention following inpatient treatment of patients with severe anorexia nervosa (AN). Method Forty female patients with AN (ICD-10: F50.0/F50.1) (aged: 15-36 years) were randomized either to an 8-week smartphone-based aftercare intervention (German version of "Recovery Record") with therapist feedback as an adjunct to treatment as usual (intervention group [IG]) or to treatment as usual alone (control group [CG]). Body mass index (BMI) and eating disorder (ED) symptoms were assessed at discharge (baseline), postintervention (after 8 weeks), and at 6-month follow-up. Additionally, patients' satisfaction, adherence to the smartphone-based intervention, and postdischarge health care utilization were evaluated. Results Patients showed a high level of adherence and reported a very high acceptance of the app and the aftercare intervention. We found at postintervention nonsignificant small to moderate between-group effect sizes favoring the IG regarding BMI (d = -0.24; 95% confidence interval [CI] [-0.90, 0.41]) and ED symptoms (Eating Disorder Examination-Questionnaire global: d = 0.56; 95% CI [-0.10, 1.22]). At 6-month follow-up, effects wore off and no significant differences between the IG and CG were evident. Discussion This was the first study to evaluate a therapist-guided smartphone-based aftercare intervention for discharged inpatients with AN. Results suggest that such an intervention is highly accepted by patients and that it could support symptom stabilization or continued improvement as an add-on therapy to treatment as usual. A larger scale randomized controlled trial is now planned to further evaluate the efficacy of this aftercare intervention for patients with AN.