Evidence map›Paper›PMID 34991715›Full record

ArticleJournal of eating disorders2022

Clinicians' perspectives on supporting individuals with severe anorexia nervosa in specialist eating disorder intensive treatment settings.

Hannah Webb, Bethan Dalton, Madeleine Irish, Daniela Mercado, Catherine McCombie, Gemma Peachey, Jon Arcelus, Katie Au, Hubertus Himmerich, A Louise Johnston and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of eating disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Hannah WebbDepartment of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.
Bethan DaltonDepartment of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.
Madeleine IrishDepartment of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.
Daniela MercadoDepartment of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.
Catherine McCombieDepartment of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Gemma PeacheySouth London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK.
Jon ArcelusInstitute of Mental Health, University of Nottingham, Jubilee Campus, Triumph Road, Nottingham, NG7 2TU, UK.
Katie AuSouth London and Maudsley NHS Foundation Trust, Maudsley Hospital, Denmark Hill, London, SE5 8AZ, UK.
Hubertus HimmerichDepartment of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.
A Louise JohnstonNHS Grampian, Aberdeen, UK.
Stanimira LazarovaSouth West London and St George's Mental Health NHS Trust, London, UK.
Tayeem PathanSurrey and Boarder Partnership NHS Foundation Trust, Surrey, UK.
Paul RobinsonDivision of Medicine, University College London, 5 University Street, London, WC1E 6JF, UK.
Janet TreasureDepartment of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK.
Ulrike Schmidt *Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, SE5 8AF, UK. ulrike.schmidt@kcl.ac.uk.ORCID http://orcid.org/0000-0003-1335-1937
Vanessa Lawrence *Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

Funding

National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme 17/123/03
6 · The paper itself

Abstract

backgroundAdmissions to intensive treatment (i.e., inpatient [IP] and/or day patient [DP]) for individuals with severe anorexia nervosa (AN) are common. Growing literature indicates potential risks and benefits of each intensive treatment approach; however, existing research has focused on patient and carer perspectives of these treatments. Also, there is scant empirical evidence available for guiding the parameters of intensive treatments for AN. We therefore explored clinicians' perspectives and experience of supporting adults with severe AN in intensive settings.

methodsWe conducted twenty one semi-structured interviews with clinicians who deliver intensive treatments (i.e., IP and/or DP) for individuals with severe AN across four specialist Eating Disorder Services in the United Kingdom between May 2020 and June 2021. We asked clinicians about their views and experiences of supporting individuals with severe AN in intensive treatment settings and the challenges and opportunities associated with IP and DP treatment. Data were analysed using reflexive thematic analysis supported by NVivo software.

resultsFive broad and interrelated themes were identified: (1) Intensive Support; (2) The Severity of Patients' Illnesses; (3) Hope and Recovery; (4) Which Treatment When; (5) Limited Resources; and (6) Carer Burden. We identified various similarities between the two intensive treatment approaches, including the value of intensive and multidisciplinary support and carer involvement, and the challenge of managing complex and unique needs in resource-limited intensive settings. We also found differences in the relationship of treatment to patients' home environments, the necessity of patient motivation, and the management of risk.

conclusionsBoth intensive treatment settings are valued by clinicians; however, there are unique challenges and opportunities for supporting individuals with severe AN within each. Our findings suggest DP treatment may be used as an alternative to IP treatment for individuals with severe AN. However, clear questions remain over which intensive treatment setting is best suited to which patient when and should be the focus of future research.

Indexed as

Anorexia nervosaCliniciansDay patientEating disordersHealthcare professionalsInpatientIntensive treatmentQualitative research

Identifiers

PMID34991715
PMCPMC8733908

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.