A Retrospective Chart Review Suggests That Coordinated, Multidisciplinary Treatment for Patients with Anorexia Nervosa Improves Odds of Weight Restoration

Figures & data

Table 1 Descriptive Statistics for the Total Sample and Within Experimental Groups (Counts (%) or Means (SDs))

Variable	Level	Group A (n = 48)	Group B (n = 290)	Group C (n = 26)	Group Difference p-value
Sex	Female	32 (10.2%)	257 (82.1%)	24 (7.7%)	< 0.001
	Male	16 (31.3%)	33 (64.7%)	2 (3.9%)
Race	White	40 (12.7%)	249 (79.6%)	24 (7.7%)	0.563
	Non-White	8 (15.7%)	41 (80.4%)	2 (3.9%)
Severity	Low (Mild-Moderate)	45 (14.0%)	256 (79.8%)	20 (6.2%)	0.101
	High (Severe-Extreme)	3 (7.0%)	34 (79.0%)	6 (14.0%)
Age at First ED Diagnosis (years)		14.9 (8.7)	15.8 (5.4)	15.3 (3.7)	0.575
Age at Most Recent Visit (years)		17.5 (10.2)	20.1 (7.5)	21.0 (5.2)	0.098
Documented Time in Treatment (years)		2.9 (3.4)	4.9 (4.0)	6.7 (3.5)	< 0.001
BMI (kg/m^2) First Diagnosis		16.9 (2.8)	17.9 (4.3)	16.8 (2.2)	0.514

Notes: Group A is hospital care only; Group B is uncoordinated care from 1–2 providers; Group C is coordinated care from 3 providers; Prevalence is % of variable level. bold denotes statistical significance.

Abbreviations: SD, stands for standard deviation; ED, stands for eating disorder; BMI, stands for body mass index.

Table 2 Parameter Estimates Predicting Documented Time-in-Treatment (in Years) Using Robust Linear Regression

Predictor	Level	b-Coefficient	95% Confidence Interval	p-value
Treatment Group	Group A	Referent	Referent	Referent
	Group B	1.3	−0.9 to 3.7	0.235
	Group C	3.9^†	0.8 to 7.0	0.013
Severity	Mild/Moderate	Referent	Referent	Referent
	Severe/Extreme	−2.8^†	−5.5 to −0.2	0.034
Group x Severity	Group A x Mild/Moderate	Referent	Referent	Referent
	Group B x Severe/Extreme	5.9^†	2.5 to 9.3	0.001
	Group C x Severe/Extreme	3.2	−0.4 to 6.7	0.077
Age Group	Adolescents	Referent	Referent	Referent
	Adults	−1.4^†	−2.7 to 0.0	0.049

Notes: Group A is hospital care only; Group B is uncoordinated care from 1–2 providers; Group C is coordinated care from 3 providers; bold and ^†denotes statistical differences compared to Group A, p < 0.05.

Figure 1 Mean documented time-in-treatment across treatment groups.

Notes: Group A is hospital care only; Group B is uncoordinated care from 1 to 2 providers; Group C is coordinated care from 3 providers; ^† denotes statistical differences compared to Group A, p < 0.05.

Figure 2 Mean documented time-in-treatment across treatment groups, stratified by disease severity.

Notes: Group A is hospital care only; Group B is uncoordinated care from 1 to 2 providers; Group C is coordinated care from 3 providers; ^† denotes statistical differences compared to Group A, p < 0.05.

Table 3 Parameter Estimates (Odds Ratios) Predicting Weight Restoration Using a Generalized Linear Mixed-Effects Model

Predictor	Level	Odds Ratio	95% Confidence Interval	p-value
Group	A	Referent	Referent	Referent
	B	1.73	0.86 to 3.52	0.125
	C	3.76^†	1.04 to 13.54	0.042
Documented Time-in-Treatment		1.08^†	1.02 to 1.16	0.015
Severity	Mild/Moderate	Referent	Referent	Referent
	Severe/Extreme	0.14^†	0.07 to 0.30	< 0.001
Age Group	Adolescents	Referent	Referent	Referent
	Adults	1.95^†	1.18 to 3.24	0.009

Notes: Group A is hospital care only; Group B is uncoordinated care from 1–2 providers; Group C is coordinated care from 3 providers; bold and ^†denotes statistical significance, p < 0.05.

Figure 3 Probability of weight restoration in anorexia nervosa recovery among treatment groups stratified by disease severity.

Notes: Group A is hospital care only; Group B is uncoordinated care from 1 to 2 providers; Group C is coordinated care from 3 providers.

Table 4 Parameter Estimates (Odds Ratios) Predicting Anorexia Nervosa Recovery Using Markov Transition Model

Predictor	Level	Odds Ratio	95% Confidence Interval	p-value
Treatment Group x Visit Number	Group A x Visit Number	0.957	0.878 to 1.053	0.160
	Group B x Visit Number	1.006^†	1.003 to 1.010	0.001
	Group C x Visit Number	1.005^†	1.001 to 1.011	0.021
Documented Time-in-Treatment (year)		1.101^†	1.041 to 1.180	0.011
Lag Variable 1		29.161^†	21.542 to 36.322	< 0.001
Lag Variable 2		4.009^†	3.111 to 5.008	< 0.001

Notes: Group A is hospital care only; Group B is uncoordinated care from 1–2 providers; Group C is coordinated care from 3 providers; bold and ^†denotes statistical significance, p < 0.05.

Abbreviations: AN, anorexia nervosa; EMR, electronic medical record; BMI, body mass index; BMI%ile, BMIpercentile; DSM, diagnostic and statistical manual; FBT, family-based treatment; CBT, cognitive behavioral therapy; DBT, dialectic and behavioral therapy; LCSW, licensed clinical social worker; GEE, generalized estimate equation; OR, odds ratio.