Cargando…

The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes

BACKGROUND: First Episode Rapid Early Intervention for Eating Disorders (FREED) is a service model and care pathway for emerging adults aged 16 to 25‐years with a recent onset eating disorder (ED) of <3 years. A previous single‐site study suggests that FREED significantly improves clinical outcom...

Descripción completa

Detalles Bibliográficos
Autores principales: Austin, Amelia, Flynn, Michaela, Shearer, James, Long, Mike, Allen, Karina, Mountford, Victoria A., Glennon, Danielle, Grant, Nina, Brown, Amy, Franklin‐Smith, Mary, Schelhase, Monique, Jones, William Rhys, Brady, Gabrielle, Nunes, Nicole, Connan, Frances, Mahony, Kate, Serpell, Lucy, Schmidt, Ulrike
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wiley Publishing Asia Pty Ltd 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291113/
https://www.ncbi.nlm.nih.gov/pubmed/33781000
http://dx.doi.org/10.1111/eip.13139
_version_ 1784749067987845120
author Austin, Amelia
Flynn, Michaela
Shearer, James
Long, Mike
Allen, Karina
Mountford, Victoria A.
Glennon, Danielle
Grant, Nina
Brown, Amy
Franklin‐Smith, Mary
Schelhase, Monique
Jones, William Rhys
Brady, Gabrielle
Nunes, Nicole
Connan, Frances
Mahony, Kate
Serpell, Lucy
Schmidt, Ulrike
author_facet Austin, Amelia
Flynn, Michaela
Shearer, James
Long, Mike
Allen, Karina
Mountford, Victoria A.
Glennon, Danielle
Grant, Nina
Brown, Amy
Franklin‐Smith, Mary
Schelhase, Monique
Jones, William Rhys
Brady, Gabrielle
Nunes, Nicole
Connan, Frances
Mahony, Kate
Serpell, Lucy
Schmidt, Ulrike
author_sort Austin, Amelia
collection PubMed
description BACKGROUND: First Episode Rapid Early Intervention for Eating Disorders (FREED) is a service model and care pathway for emerging adults aged 16 to 25‐years with a recent onset eating disorder (ED) of <3 years. A previous single‐site study suggests that FREED significantly improves clinical outcomes compared to treatment‐as‐usual (TAU). The present study (FREED‐Up) assessed the scalability of FREED. A multi‐centre quasi‐experimental pre‐post design was used, comparing patient outcomes before and after implementation of FREED in participating services. METHODS: FREED patients (n = 278) were consecutive, prospectively ascertained referrals to four specialist ED services in England, assessed at four time points over 12 months on ED symptoms, mood, service utilization and cost. FREED patients were compared to a TAU cohort (n = 224) of similar patients, identified retrospectively from electronic patient records in participating services. All were emerging adults aged 16–25 experiencing a first episode ED of <3 years duration. RESULTS: Overall, FREED patients made significant and rapid clinical improvements over time. 53.2% of FREED patients with anorexia nervosa reached a healthy weight at the 12‐month timepoint, compared to only 17.9% of TAU patients (X (2) [1, N = 107] = 10.46, p < .001). Significantly fewer FREED patients required intensive (i.e., in‐patient or day‐patient) treatment (6.6%) compared to TAU patients (12.4%) across the follow‐up period (X (2) [1, N = 40] = 4.36, p = .037). This contributed to a trend in cost savings in FREED compared to TAU (−£4472, p = .06, CI −£9168, £233). DISCUSSION: FREED is robust and scalable and is associated with substantial improvements in clinical outcomes, reduction in inpatient or day‐patient admissions, and cost‐savings.
format Online
Article
Text
id pubmed-9291113
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Wiley Publishing Asia Pty Ltd
record_format MEDLINE/PubMed
spelling pubmed-92911132022-07-20 The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes Austin, Amelia Flynn, Michaela Shearer, James Long, Mike Allen, Karina Mountford, Victoria A. Glennon, Danielle Grant, Nina Brown, Amy Franklin‐Smith, Mary Schelhase, Monique Jones, William Rhys Brady, Gabrielle Nunes, Nicole Connan, Frances Mahony, Kate Serpell, Lucy Schmidt, Ulrike Early Interv Psychiatry Early Intervention in the Real World BACKGROUND: First Episode Rapid Early Intervention for Eating Disorders (FREED) is a service model and care pathway for emerging adults aged 16 to 25‐years with a recent onset eating disorder (ED) of <3 years. A previous single‐site study suggests that FREED significantly improves clinical outcomes compared to treatment‐as‐usual (TAU). The present study (FREED‐Up) assessed the scalability of FREED. A multi‐centre quasi‐experimental pre‐post design was used, comparing patient outcomes before and after implementation of FREED in participating services. METHODS: FREED patients (n = 278) were consecutive, prospectively ascertained referrals to four specialist ED services in England, assessed at four time points over 12 months on ED symptoms, mood, service utilization and cost. FREED patients were compared to a TAU cohort (n = 224) of similar patients, identified retrospectively from electronic patient records in participating services. All were emerging adults aged 16–25 experiencing a first episode ED of <3 years duration. RESULTS: Overall, FREED patients made significant and rapid clinical improvements over time. 53.2% of FREED patients with anorexia nervosa reached a healthy weight at the 12‐month timepoint, compared to only 17.9% of TAU patients (X (2) [1, N = 107] = 10.46, p < .001). Significantly fewer FREED patients required intensive (i.e., in‐patient or day‐patient) treatment (6.6%) compared to TAU patients (12.4%) across the follow‐up period (X (2) [1, N = 40] = 4.36, p = .037). This contributed to a trend in cost savings in FREED compared to TAU (−£4472, p = .06, CI −£9168, £233). DISCUSSION: FREED is robust and scalable and is associated with substantial improvements in clinical outcomes, reduction in inpatient or day‐patient admissions, and cost‐savings. Wiley Publishing Asia Pty Ltd 2021-03-29 2022-01 /pmc/articles/PMC9291113/ /pubmed/33781000 http://dx.doi.org/10.1111/eip.13139 Text en © 2021 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Early Intervention in the Real World
Austin, Amelia
Flynn, Michaela
Shearer, James
Long, Mike
Allen, Karina
Mountford, Victoria A.
Glennon, Danielle
Grant, Nina
Brown, Amy
Franklin‐Smith, Mary
Schelhase, Monique
Jones, William Rhys
Brady, Gabrielle
Nunes, Nicole
Connan, Frances
Mahony, Kate
Serpell, Lucy
Schmidt, Ulrike
The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes
title The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes
title_full The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes
title_fullStr The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes
title_full_unstemmed The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes
title_short The First Episode Rapid Early Intervention for Eating Disorders ‐ Upscaled study: Clinical outcomes
title_sort first episode rapid early intervention for eating disorders ‐ upscaled study: clinical outcomes
topic Early Intervention in the Real World
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9291113/
https://www.ncbi.nlm.nih.gov/pubmed/33781000
http://dx.doi.org/10.1111/eip.13139
work_keys_str_mv AT austinamelia thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT flynnmichaela thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT shearerjames thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT longmike thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT allenkarina thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT mountfordvictoriaa thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT glennondanielle thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT grantnina thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT brownamy thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT franklinsmithmary thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT schelhasemonique thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT joneswilliamrhys thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT bradygabrielle thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT nunesnicole thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT connanfrances thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT mahonykate thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT serpelllucy thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT schmidtulrike thefirstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT austinamelia firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT flynnmichaela firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT shearerjames firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT longmike firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT allenkarina firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT mountfordvictoriaa firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT glennondanielle firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT grantnina firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT brownamy firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT franklinsmithmary firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT schelhasemonique firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT joneswilliamrhys firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT bradygabrielle firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT nunesnicole firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT connanfrances firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT mahonykate firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT serpelllucy firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes
AT schmidtulrike firstepisoderapidearlyinterventionforeatingdisordersupscaledstudyclinicaloutcomes