scholarly journals Clinical effectiveness of a skills training intervention for caregivers in improving patient and caregiver health following in-patient treatment for severe anorexia nervosa: pragmatic randomised controlled trial

BJPsych Open ◽  
2015 ◽  
Vol 1 (1) ◽  
pp. 56-66 ◽  
Author(s):  
Rebecca Hibbs ◽  
Nicholas Magill ◽  
Elizabeth Goddard ◽  
Charlotte Rhind ◽  
Simone Raenker ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Intervention Group ◽  
Skills Training ◽  
Patient Treatment ◽  
Training Intervention ◽  
Randomised Controlled ◽  
The Impact

BackgroundFamilies express a need for information to support people with severe anorexia nervosa.AimsTo examine the impact of the addition of a skills training intervention for caregivers (Experienced Caregivers Helping Others, ECHO) to standard care.MethodPatients over the age of 12 (mean age 26 years, duration 72 months illness) with a primary diagnosis of anorexia nervosa and their caregivers were recruited from 15 in-patient services in the UK. Families were randomised to ECHO (a book, DVDs and five coaching sessions per caregiver) or treatment as usual. Patient (n=178) and caregiver (n=268) outcomes were measured at discharge and 6 and 12 months after discharge.ResultsPatients with caregivers in the ECHO group had reduced eating disorder psychopathology (EDE-Q) and improved quality of life (WHO-Quol; both effects small) and reduced in-patient bed days (7–12 months post-discharge). Caregivers in the ECHO group had reduced burden (Eating Disorder Symptom Impact Scale, EDSIS), expressed emotion (Family Questionnaire, FQ) and time spent caregiving at 6 months but these effects were diminished at 12 months.ConclusionsSmall but sustained improvements in symptoms and bed use are seen in the intervention group. Moreover, caregivers were less burdened and spent less time providing care. Caregivers had most benefit at 6 months suggesting that booster sessions, perhaps jointly with the patients, may be needed to maintain the effect. Sharing skills and information with caregivers may be an effective way to improve outcomes. This randomised controlled trial (RCT) was registered with Current Controlled Trials ISRCTN06149665.

scholarly journals Out-patient psychological therapies for adults with anorexia nervosa: randomised controlled trial

2012 ◽  
Vol 201 (5) ◽  
pp. 392-399 ◽  
Author(s):  
Ulrike Schmidt ◽  
Anna Oldershaw ◽  
Fatima Jichi ◽  
Lot Sternheim ◽  
Helen Startup ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Service Utilisation ◽  
Recovery Rates ◽  
Psychological Therapies ◽  
Novel Treatment ◽  
Randomised Controlled ◽  
Eating Disorders Examination

BackgroundVery limited evidence is available on how to treat adults with anorexia nervosa and treatment outcomes are poor. Novel treatment approaches are urgently needed.AimsTo evaluate the efficacy and acceptability of a novel psychological therapy for anorexia nervosa (Maudsley Model of Anorexia Nervosa Treatment for Adults, MANTRA) compared with specialist supportive clinical management (SSCM) in a randomised controlled trial.MethodSeventy-two adult out-patients with anorexia nervosa or eating disorder not otherwise specified were recruited from a specialist eating disorder service in the UK. Participants were randomly allocated to 20 once weekly sessions of MANTRA or SSCM and optional additional sessions depending on severity and clinical need (trial registration: ISRCTN62920529). The primary outcomes were body mass index, weight and global score on the Eating Disorders Examination at end of treatment (6 months) and follow-up (12 months). Secondary outcomes included: depression, anxiety and clinical impairment; neuropsychological outcomes; recovery rates; and additional service utilisation.ResultsAt baseline, patients randomised to MANTRA were significantly less likely to be in a partner relationship than those receiving SSCM (3/34 v. 10/36; P < 0.05). Patients in both treatments improved significantly in terms of eating disorder and other outcomes, with no differences between groups. Strictly defined recovery rates were low. However, MANTRA patients were significantly more likely to require additional in-patient or day-care treatment than those receiving SSCM (7/34 v. 0/37; P=0.004).ConclusionsAdults with anorexia nervosa are a difficult to treat group. The imbalance between groups in partner relationships may explain differences in service utilisation favouring SSCM. This study confirms SSCM as a useful treatment for out-patients with anorexia nervosa. The novel treatment, MANTRA, designed for this patient group may need adaptations to fully exploit its potential.

scholarly journals A randomised controlled trial of in-patient treatment for anorexia nervosa in medically unstable adolescents

2015 ◽  
Vol 3 (S1) ◽  
Author(s):  
Sloane Madden ◽  
Jane Miskovic-Wheatley ◽  
Andrew Wallis ◽  
Michael Kohn ◽  
James Lock ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Patient Treatment ◽  
Randomised Controlled

scholarly journals A randomised controlled trial of three psychological treatments for anorexia nervosa

2017 ◽  
Vol 47 (16) ◽  
pp. 2823-2833 ◽  
Author(s):  
S. Byrne ◽  
T. Wade ◽  
P. Hay ◽  
S. Touyz ◽  
C. G. Fairburn ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Eating Disorder ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Healthy Weight ◽  
Psychological Treatments ◽  
Psychosocial Impairment ◽  
Eating Disorder Psychopathology ◽  
Randomised Controlled

BackgroundThere is a lack of evidence pointing to the efficacy of any specific psychotherapy for adults with anorexia nervosa (AN). The aim of this study was to compare three psychological treatments for AN: Specialist Supportive Clinical Management, Maudsley Model Anorexia Nervosa Treatment for Adults and Enhanced Cognitive Behavioural Therapy.MethodA multi-centre randomised controlled trial was conducted with outcomes assessed at pre-, mid- and post-treatment, and 6- and 12-month follow-up by researchers blind to treatment allocation. All analyses were intention-to-treat. One hundred and twenty individuals meeting diagnostic criteria for AN were recruited from outpatient treatment settings in three Australian cities and offered 25–40 sessions over a 10-month period. Primary outcomes were body mass index (BMI) and eating disorder psychopathology. Secondary outcomes included depression, anxiety, stress and psychosocial impairment.ResultsTreatment was completed by 60% of participants and 52.5% of the total sample completed 12-month follow-up. Completion rates did not differ between treatments. There were no significant differences between treatments on continuous outcomes; all resulted in clinically significant improvements in BMI, eating disorder psychopathology, general psychopathology and psychosocial impairment that were maintained over follow-up. There were no significant differences between treatments with regard to the achievement of a healthy weight (mean = 50%) or remission (mean = 28.3%) at 12-month follow-up.ConclusionThe findings add to the evidence base for these three psychological treatments for adults with AN, but the results underscore the need for continued efforts to improve outpatient treatments for this disorder.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ACTRN 12611000725965) http://www.anzctr.org.au/

scholarly journals Effect of an editorial intervention to improve the completeness of reporting of randomised trials: a randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036799 ◽  
Author(s):  
David Blanco ◽  
Sara Schroter ◽  
Adrian Aldcroft ◽  
David Moher ◽  
Isabelle Boutron ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Peer Review ◽  
Controlled Trial ◽  
Intervention Group ◽  
Secondary Outcome ◽  
Control Group ◽  
Randomised Trials ◽  
Randomised Controlled ◽  
The Impact ◽  
Completeness Of Reporting

ObjectiveTo evaluate the impact of an editorial intervention to improve completeness of reporting of reports of randomised trials.DesignRandomised controlled trial (RCT).SettingBMJ Open’s quality improvement programme.Participants24 manuscripts describing RCTs.InterventionsWe used an R Shiny application to randomise manuscripts (1:1 allocation ratio, blocks of 4) to the intervention (n=12) or control (n=12) group. The intervention was performed by a researcher with expertise in the content of the Consolidated Standards of Reporting Trials (CONSORT) and consisted of an evaluation of completeness of reporting of eight core CONSORT items using the submitted checklist to locate information, and the production of a report containing specific requests for authors based on the reporting issues found, provided alongside the peer review reports. The control group underwent the usual peer review.OutcomesThe primary outcome is the number of adequately reported items (0–8 scale) in the revised manuscript after the first round of peer review. The main analysis was intention-to-treat (n=24), and we imputed the scores of lost to follow-up manuscripts (rejected after peer review and not resubmitted). The secondary outcome is the proportion of manuscripts where each item was adequately reported. Two blinded reviewers assessed the outcomes independently and in duplicate and solved disagreements by consensus. We also recorded the amount of time to perform the intervention.ResultsManuscripts in the intervention group (mean: 7.01; SD: 1.47) were more completely reported than those in the control group (mean: 5.68; SD: 1.43) (mean difference 1.43, 95% CI 0.31 to 2.58). We observed the main differences in items 6a (outcomes), 9 (allocation concealment mechanism), 11a (blinding) and 17a (outcomes and estimation). The mean time to perform the intervention was 87 (SD 42) min.ConclusionsWe demonstrated the benefit of involving a reporting guideline expert in the editorial process. Improving the completeness of RCTs is essential to enhance their usability.Trial registration numberNCT03751878.

scholarly journals Smartphone-Enhanced Low-Threshold Intervention for adolescents with Anorexia Nervosa (SELTIAN) waiting for outpatient psychotherapy: study protocol of a randomised controlled trial

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e018049 ◽  
Author(s):  
David R Kolar ◽  
Florian Hammerle ◽  
Ekkehart Jenetzky ◽  
Michael Huss
Keyword(s):  
Anorexia Nervosa ◽  
Randomised Controlled Trial ◽  
Waiting Time ◽  
Study Protocol ◽  
Controlled Trial ◽  
Intervention Group ◽  
Outpatient Psychotherapy ◽  
Reference Number ◽  
Low Threshold ◽  
Randomised Controlled

IntroductionAs smartphones are widely distributed nowadays, mental health apps seem to be a promising treatment tool. First self-help apps for eating disorders have been developed recently. However, studies assessing the efficacy of such apps are scarce. A smartphone app could prevent further weight reduction and increase commitment during waiting time for outpatient treatment, especially for adolescents with anorexia nervosa (AN). In this study protocol, a randomised controlled trial to assess the efficacy of a smartphone-enhanced low-threshold intervention for AN during waiting time is described.Methods and analysis30 adolescents with AN aged 12–19 years will be recruited at three child and adolescent psychiatry centres in Germany. All participants will be randomised to consultations only or consultations and the use of the Jourvie Research app. The app will be installed either on their own smartphone or on a research device. The participants will receive biweekly to monthly consultations for 3 months to review meal plans and weight management with a clinician. In addition, the Jourvie Research app for meal, behaviour and emotion protocolling will be provided to the intervention group. The protocols will be discussed with a clinician during the consultations. Dialectical behaviour therapy-informed skills for tension regulation to increase compliance with the meal plan will be taught in the intervention group and the app will remind the participant of a skill in a moment of need. The primary outcome is the age-adjusted and height-adjusted weight gain in standard deviation score after 3 months.Ethics and disseminationResults will be disseminated at conferences and through peer-reviewed publications. The trial was approved by the ethics review board of the local medical association, Mainz, Germany, under the reference number 837.338.15.Trial registration numberGerman clinical trials register, reference number DRKS00008946.

scholarly journals Effect of a 2-day communication skills training on nursing and midwifery students’ empathy: a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023666 ◽  
Author(s):  
Mustapha Alhassan
Keyword(s):  
Randomised Controlled Trial ◽  
Communication Skills ◽  
Controlled Trial ◽  
Intervention Group ◽  
Skills Training ◽  
Baseline Data ◽  
Control Group ◽  
Communication Skills Training ◽  
Post Test ◽  
Randomised Controlled

IntroductionEmpathy is crucial to the fundamental aim and achievement of nursing and midwifery goals. Researchers agree on the positive role empathy plays in interpersonal relationships when providing healthcare. Models of good communication have been developed to assist nurses, midwives and doctors to improve their ability to communicate with patients. This study investigated the effect of a 2-day communication skills training (CST) on nursing and midwifery students’ empathy in a randomised controlled trial.MethodsThe two groups had a baseline data collection at the same time. The intervention group had a CST, followed by post-test on day 3. The control group had post-test on day 4 just before their CST. The empathy outcome was measured with Jefferson Scales of Empathy-Health Professions Student version. Both groups had a follow-up test at the same time 6 months after the CST.ResultsIn this study, there was no statistically significant difference in the scores of empathy between the groups F(1, 171)=0.18, p=0.675. The intervention group had baseline T1 (M=109.8, SD=9.8, d=0.160), and post-test T2 (M=111.9, SD=9.0, d=0.201), whereas the control group had baseline T1 (M=107.9, SD=11.46, d=0.160), and post-test T2 (M=110.0, SD=11.0, d=0.201). Baseline data were collected on 15 June 2013.ConclusionsThis study has shown that empathy may not be enhanced within a short period after CST.

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