Weight
The patient’s weight (in pounds) was taken by parents twice weekly, and
communicated via text from parents to Equip’s HIPAA compliant platform.
Parents also provided a weight update at four weeks post discharge.
Target weight was calculated using expected weight data from each
patient’s CDC BMI-for-age Growth Charts.
Results:
Patient characteristics and outcome data are reported in Table 1. In
terms of our primary outcome, both patients gained at least 1 pound per
week over the course of the trial (6.4 and 4.2 lbs in four weeks
respectively). For secondary outcomes, scores for EDE-QS decreased by 7
and 12 points, suggesting a marked decrease in eating disorder symptoms.
Relatively little change was noted in PHQ-9 and GAD-7 scores, with one
participant scoring ‘mild’ at baseline and discharge on both
assessments, and the other scoring ‘moderate’ at baseline and discharge
on both assessments. Patients and parents attended 18 and 16 sessions,
respectively, though parents of patient 2 engaged with the team via the
‘chat’ feature at a much higher frequency. Both parents and patients
reported that they would ‘definitely recommend’ Equip to a friend or
family.
Discussion:
The beta trial patients demonstrated a positive response to Equip’s
treatment model, as both patients gained at least one pound per week
during the trial. In terms of secondary outcomes, there was a decrease
in EDE-QS scores for both patients however GAD-7 and PHQ-9 remained
stable and subclinical over the course of treatment. Further, both
patients continued to progress with weight restoration after treatment
ended. Patients and parents were both highly engaged during the trial
with both traditional providers (therapist and dietitian) as well as
mentors. This was promising given potential for loss of rapport or
connection when care is virtually delivered. Having the additional
support from the ‘lived experience’ vantage point with the addition of
mentors to the treatment team may overcome perceived limitations related
to virtual care. Parents and patients were very satisfied with the
approach overall, and verbally expressed finding great value in the
unique support received from all four team members.
This case study’s results are limited by the short intervention period
and use of non-validated measurement tools in regard to satisfaction and
engagement scores. Further, we have limited data post-discharge (weight
only). Engagement and satisfaction may be influenced by treatment being
at no cost, and thus expectations of paid patients may differ.
Additionally, further investigation is needed to ensure that other
patients show similar improvements with the treatment approach, although
the report of these two cases is promising.
These findings offer preliminary support for achieving meaningful
clinical outcomes using Equip’s virtually delivered augmented FBT model.
If future studies of this approach that include larger samples, longer
follow-up periods, and comparison treatments replicate the outcomes from
these cases, the treatment approach could be crucial for addressing
limitations in access to care for families living far from trained FBT
specialists.
Author Contributions
Megan Hellner’s primary contributions were as follows:
-Conception of the study; review of literature; data analysis and
interpretation; initial draft of the manuscript; critical revision of
manuscript and approval of final version prior to submitting for
publication.
Sam Kolander’s primary contributions were as follows:
-Interpretation of data; initial draft of the manuscript; critical
revision of the manuscript and approval of the final version prior to
submitting for publication.
Cara Bohon’s primary contributions were as follows:
-Review of literature; Interpretation of data; critical revision of the
manuscript and approval of the final version of the manuscript prior to
submitting for publication.
Erin Parks’ primary contributions were as follows:
-Conception of the study; collection of data; final approval of the
version of the manuscript prior to submitting for publication.
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