An Eleven Site National Quality Improvement Evaluation of Adolescent Medicine-Based Eating Disorder Programs: Predictors of Weight Outcomes at One Year and Risk Adjustment Analyses
An Eleven Site National Quality Improvement Evaluation of Adolescent Medicine-Based Eating Disorder Programs: Predictors of Weight Outcomes at One Year and Risk Adjustment Analyses
复制标题
DOI：
10.1016/j.jadohealth.2011.04.023
复制
发表时间：
2011-12-01
影响因子：
7.6
通讯作者：
Woods, Elizabeth R.
中科院分区：
文献类型：
--
作者：
Forman, Sara F.;Grodin, Leah F.;Woods, Elizabeth R.
目的：这个质量改进项目收集和分析了短期的体重增加的数据，为患者限制性进食障碍（ED）治疗的门诊青少年医学为基础的艾德programmesnational.Methods：数据介绍和治疗的低体重艾德患者年龄在9-21岁，在2006年进行了回顾性收集11个独立的艾德程序在摄入量和1年的随访。低体重定义为< 90%的中位体重（MBW），这是特定于年龄的。分析每个程序的治疗组分。每个研究中心在1年时对体重增加进行风险调整，解释在双变量分析中确定为显著的临床变量。（总N = 267）;平均年龄为14.1-17.1岁;摄入前疾病持续时间为5.7-18.6个月;摄入时MBW %为77.5-83.0;随访时MBW %为88.8-93.8。一般而言，40%-63%的低体重艾德受试者在1年随访时达到>= 90% MBW。在入院时，具有较高MBW %（p = .0002）和较短病程（p = .01）的患者在随访时更有可能>= 90% MBW。控制% MBW和疾病持续时间的风险调整比值比为0.8（0.5，1.4）-1.3（0.3，3.8），在站点之间没有显著差异。结论：共有11个艾德项目成功地比较了质量改进数据。摄入前疾病持续时间越短，MBW %越高，1年时体重结局越好。调整风险因素后，项目结果没有显着差异。所有以药物为基础的青少年艾德计划在帮助患者增加体重方面都是有效的。(C)2011年青少年健康和医学协会。All rights reserved.
Purpose: This quality improvement project collected and analyzed short-term weight gain data for patients with restrictive eating disorders (EDs) treated in outpatient adolescent medicine-based ED programs nationally.Methods: Data on presentation and treatment of low-weight ED patients aged 9-21 years presenting in 2006 were retrospectively collected from 11 independent ED programs at intake and at 1-year follow-up. Low-weight was defined as < 90% median body weight (MBW) which is specific to age. Treatment components at each program were analyzed. Risk adjustment was performed for weight gain at 1 year for each site, accounting for clinical variables identified as significant in bivariate analyses.Results: The sites contained 6-51 patients per site (total N = 267); the mean age was 14.1-17.1 years; duration of illness before intake was 5.7-18.6 months; % MBW at intake was 77.5-83.0; and % MBW at follow-up was 88.8-93.8. In general, 40%-63% of low weight ED subjects reached >= 90% MBW at 1-year follow-up. At intake, patients with higher % MBW (p = .0002) and shorter duration of illness (p = .01) were more likely to be >= 90% MBW at follow-up. Risk-adjusted odds ratios controlled for % MBW and duration of illness were .8 (.5, 1.4)-1.3 (.3, 3.8), with no significant differences among sites.Conclusion: A total of 11 ED programs successfully compared quality improvement data. Shorter duration of illness before intake and higher % MBW predicted improved weight outcomes at 1 year. After adjusting for risk factors, program outcomes did not differ significantly. All adolescent medicine-based ED programs were effective in assisting patients to gain weight. (C) 2011 Society for Adolescent Health and Medicine. All rights reserved.