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Boston, MA, United States

Forman S.F.,Childrens Hospital Boston LO 306 | Grodin L.F.,Childrens Hospital Boston LO 306 | Graham D.A.,Program for Patient Safety and Quality | Sylvester C.J.,Childrens Hospital Boston LO 306 | And 15 more authors.
Journal of Adolescent Health

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 921 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 651 patients per site (total N = 267); the mean age was 14.117.1 years; duration of illness before intake was 5.718.6 months; % MBW at intake was 77.583.0; and % MBW at follow-up was 88.893.8. 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. © 2011 Society for Adolescent Health and Medicine. Source

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