Carer Skills Training for Inpatients With Anorexia Nervosa (iCASK)

James Adamson31 enrolled

Overview

To improve treatment for patients with severe anorexia nervosa admitted for inpatient care, and to help their families. Inpatients and their families will be offered a novel intervention which includes multimedia training materials. These materials provide guidance in how families can provide support to maintain and build on changes made during inpatient care

Problem to be solved: Hospital Episode Statistics reveal that admissions for anorexia nervosa are increasing \[1\]. Admission restores nutrition in a timely manner \[2\], but psychosocial problems remain and relapse following discharge is common \[3\]. The mortality post discharge is high \[4\]. We have found that relapse and bed use post discharge are reduced by a parenting intervention giving the family skills to manage eating disorder behaviours \[5\]. Innovation: Through a process of co-production, in collaboration with service users and their families, we have developed tools exemplifying emotional coaching behaviour change strategies for patients and their carers (texts, DVDs and podcasts; iCASK programme). These aim of these tools is to improve the transition to outpatient care. These are hosted on a user-friendly, confidential and NHS-compliant platform.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Anorexia Nervosa

Interventions

iCASKBEHAVIORAL

Materials and support to aid transitions

Eligibility

Sex: FEMALEMin age: 17 YearsMax age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * aged 17 or over * DSM-5 diagnosis of Anorexia Nervosa with a body mass index (BMI) of \< 18.5 kg/m2 Exclusion Criteria: * Insufficient knowledge of English * Severe mental or physical illness needing treatment in its own right (e.g. psychosis or diabetes mellitus)

Locations (1)

Tyson West 2, Bethlem Royal Hospital

Beckenham, Kent, United Kingdom

Outcomes

Primary Outcomes

weight change

weight change over the admission (weight and height will be combined to report BMI in kg/m\^2)

Time frame: at time of admission, at time of discharge (average 12-14 weeks)

Secondary Outcomes

Self-Report Questionnaires to assess psychopathological change for patients over admission and post-discharge.

Battery of quantitative self report measures for patients administered at admission, discharge and 3-month follow up. Primary Questionnaire: EDEQ (Eating Disorders Questionnaire) - Global score calculated for each time point to assess psychopathological change over time. Reduction in global score would indicate an improvement. Secondary Measure: A reduction in scores would indicate an improvement, except for AQ-10 which should remain constant if true Autism detected. Scores will be assessed individually using total scores but then combined with EDEQ to look overall at psychopathological change over time. WSAS (Social Adjustment) - Total Score AQ-10 (Autism Quotient) - Total Score indicates levels of autism symptoms. HADS (Anxiety and Depression Scale) - Total Score MR (Motivational Ruler) - Total Score

Time frame: Questionnaires are administered at time of admission, at time of discharge (average 12-14 weeks) and 3 months post-discharge.

Self-Report Questionnaires for carers, to assess change in perceived burden over admission and post-discharge.

Battery of quantitative self report measures for carers administered at admission, discharge and 3-month follow up. Questionnaire total scores are calculated to provide overview of carer burden. Sub-scales are not used. Carer Questionnaires: A decrease in overall scores would indicate an improvement. Burden: DASS (Depression, Anxiety and Stress Scale) - Total Score used EDSIS (Eating Disorder Symptom Impact Scale) - Total Score used PvAN (Parent vs Anorexia Scale) - Total Score used AESED (accommodation and enabling scale for eating disorders) - Total Score used

Time frame: Questionnaires are administered at time of admission, at time of discharge (average 12-14 weeks) and 3 months post-discharge.

Data from ClinicalTrials.gov

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