Long-term outcomes of intensive multidisciplinary intervention for feeding tube dependence and chronic food refusal.

Objectives: To evaluate the long-term follow-up status of patients with a history of feeding tube dependence who completed a multidisciplinary, day treatment program. Method: We conducted a 17-item Qualtrics survey of patients who participated in treatment to improve the volume and variety of solid food intake and replace enteral feeding due to chronic food refusal an average of 6 years following intervention. Results: Of the 81 patients included in the original outcome study, 75 met eligibility criteria; 36 caregivers (48%) completed the survey. Survey respondents and non-respondents were similar in terms of patient demographics and status at discharge. Most patients (80%) who achieved full wean from feeding tube dependence at program discharge maintained their wean at the time of the survey. Most caregivers (89%) described their child's relationship with food as "good" or "neutral". Discussion: Intensive multidisciplinary intervention holds benefits for children with complex feeding problems, including advancing the volume and variety of food consumed during meals and reducing the need for enteral feeding. The durability of these benefits, however, is not well understood. The current follow-up survey of patients who completed an intensive feeding program suggests that treatment gains, such as the reduction of tube dependency, endure for most patients. Conclusion: Our findings provide provisional evidence of the long-term effectiveness of our intensive multidisciplinary model in promoting oral intake and reducing tube dependence among young children with chronic food refusal. Future research should seek to better understand who benefits most from this model of care.