Cynthia Kapphahn

Publication Details

  • An Eleven Site National Quality Improvement Evaluation of Adolescent Medicine-Based Eating Disorder Programs: Predictors of Weight Outcomes at One Year and Risk Adjustment Analyses JOURNAL OF ADOLESCENT HEALTH Forman, S. F., Grodin, L. F., Graham, D. A., Sylvester, C. J., Rosen, D. S., Kapphahn, C. J., Callahan, S. T., Sigel, E. J., Bravender, T., Peebles, R., Romano, M., Rome, E. S., Fisher, M., Malizio, J. B., Mammel, K. A., Hergenroeder, A. C., Buckelew, S. M., Golden, N. H., Woods, E. R. 2011; 49 (6): 594-600


    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.Data on presentation and treatment of low-weight ED patients aged 9-21 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.The sites contained 6-51 patients per site (total N = 267); the mean age was 14.1-17.1 years; duration of illness before intake was 5.7-18.6 months; % MBW at intake was 77.5-83.0; and % MBW at follow-up was 88.8-93.8. 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.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.

    View details for DOI 10.1016/j.jadohealth.2011.04.023

    View details for Web of Science ID 000297261000005

    View details for PubMedID 22098769

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