Document Detail


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.
MedLine Citation:
PMID:  22098769     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
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.
Authors:
Sara F Forman; Leah F Grodin; Dionne A Graham; Cara J Sylvester; David S Rosen; Cynthia J Kapphahn; S Todd Callahan; Eric J Sigel; Terrill Bravender; Rebecka Peebles; Mary Romano; Ellen S Rome; Martin Fisher; Joan B Malizio; Kathleen A Mammel; Albert C Hergenroeder; Sara M Buckelew; Neville H Golden; Elizabeth R Woods;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of adolescent health : official publication of the Society for Adolescent Medicine     Volume:  49     ISSN:  1879-1972     ISO Abbreviation:  J Adolesc Health     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102136     Medline TA:  J Adolesc Health     Country:  United States    
Other Details:
Languages:  eng     Pagination:  594-600     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, Boston, Massachusetts.
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