A real-world feasibility trial embedding telehealth-delivered treatment solutions for adolescent Anorexia Nervosa in rural health services

Abstract

Background: Family-based treatment (FBT) is an efficacious outpatient intervention for young people diagnosed with Anorexia Nervosa (AN). Yet rural young people face access inequities, with a limited trained workforce. Telehealth has been proposed as a potential solution to rural access challenges, however, little is known about its safety, effectiveness and feasibility, particularly in real-world community settings. To this end, this study determined the feasibility and preliminary efficacy of telehealth-delivered FBT to young people with AN accessing care in the rural health system.   Methods: Young people (89.29% female, average age 14.68¬±1.58 years) and their families were recruited to the multi-site pre- and post-implementation study. Feasibility and acceptability were evaluated by rates of recruitment and retention. Treatment outcome was determined by change in percent median body mass index (%mBMI) and eating disorder symptoms from baseline to end of treatment and six-months follow up.   Results: Twenty young people (71.43%) met the diagnostic criteria for AN (baseline 86.03%mBMI¬±7.14), and eight (28.57%) for AAN (baseline 101.34%mBMI¬±8.28), with an overall mean duration of illness of 8.53 months (SD=5.39, range 2-24 months). Significant improvements were observed in %mBMI and ED symptoms from baseline to end of treatment. At six-months follow-up, young people's weight was significantly improved from baseline and ED symptoms remained stable.   Conclusion: This study provides evidence to the developing literature supporting the use of telehealth to deliver FBT, and importantly, how FBT can be safely and effectively implemented into complex rural health pathways. The clinical and health system implications of these results are discussed.