Variations in Admission Practices for Adolescents with Anorexia Nervosa: A North American Sample
Received 12 December 2007; accepted 9 April 2008. published online 25 June 2008.
Refers to article:
Variability in Admission Practices for Teens Hospitalized with Anorexia Nervosa: A Call for Evidence-based Outcome Studies
Neville H. Golden
Journal of Adolescent Health
November 2008 (Vol. 43, Issue 5, Pages 417-418) Full Text |
Full-Text PDF (178 KB)
Abstract
Purpose
The purpose of this study was to assess the variability in admission practices and medical inpatient care for adolescent patients with anorexia nervosa (AN).
Methods
Participants consisted of members of the 2001–2003 Eating Disorder Special Interest Group from the Society for Adolescent Medicine who completed a structured telephone interview about their admission practices and patterns of inpatient care for teens with AN. Questions focused on admission threshold for heart rate (HR), percentage of ideal body weight (% IBW), and refeeding protocols. Case vignettes were used.
Results
Of 95 eligible practitioners, 51 (53%) agreed to participate. Participants represented 25 American states, one Canadian province, and 45 different adolescent programs. The majority of physicians reported they would hospitalize an AN patient with HR <40 beats/min. The most common response for when to hospitalize based on % IBW was 75% IBW. There were no differences in admission practices based on number of years in practice, gender of physician, or practice setting. Regional differences in admission practices were noted, with physicians in the western United States less likely to admit patients with HR ≥40 beats per minute (p = .018). Physicians described 28 different methods of advancing a diet during an admission. Only 37% of physicians were aware of a standardized refeeding protocol in their institution.
Conclusion
This study indicates variability in admission criteria and refeeding practices and shows evidence of geographic variations of admission standards. These data provide a baseline for outcome trials investigating medical admissions for adolescents with AN.
aDivision of Adolescent/Young Adult Medicine, Children's Hospital Boston, Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
bDivision of Adolescent Medicine, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
Address correspondence to: Sara Forman, M.D., Division of Adolescent/Young Adult Medicine, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 20115
ABSTRACT