Medical Assessment and Triage of Pediatric Patients with Anorexia Nervosa in Primary Care.
J Dev Behav Pediatr
; 40(2): 92-98, 2019.
Article
en En
| MEDLINE
| ID: mdl-30747833
ABSTRACT
OBJECTIVE:
To examine the medical assessment and triage of pediatric patients with anorexia nervosa (AN) initially seen in primary care.METHODS:
A retrospective cohort study was conducted for all pediatric patients with AN who had eating/weight concerns and initially identified symptoms in primary care in a single health care system between January 1, 2010, and December 31, 2016. Information on presenting concern, medical assessment/laboratory tests, clinical diagnoses, treatment recommendations, and referrals were abstracted from the medical record.RESULTS:
Forty-one (mean age = 13.7 years; SD = 2.2) pediatric patients with AN had eating/weight concerns and initially identified symptoms in a primary care. Overall, only 5% (n = 2/41) of patients received an AN diagnosis during the index visit; a minority were assessed for electrolyte disturbance (n = 20), electrocardiogram abnormality (n = 18), hypothermia (n = 13), binge/purge behaviors (n = 13), orthostatic hypotension (n = 2), or dehydration (n = 1), and only 56% (n = 23) received triage consistent with practice recommendations. Although 61% (n = 25) met criteria for inpatient admission, inpatient hospitalization was recommended for only 2 patients. Patients who received triage consistent with practice recommendations received AN diagnosis and treatment significantly earlier than those who did not (p < 0.01 and p = 0.001, respectively).CONCLUSION:
Findings suggest that pediatric patients with AN may not be receiving medical assessment and triage per practice recommendations in the primary care setting. Understanding barriers to evidence-based care for pediatric eating disorders may inform provider education and system-wide changes to enhance outcomes in these patients.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Atención Primaria de Salud
/
Anorexia Nerviosa
/
Triaje
/
Hospitalización
Tipo de estudio:
Guideline
/
Observational_studies
/
Prognostic_studies
Límite:
Adolescent
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Child
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Female
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Humans
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Male
Idioma:
En
Año:
2019
Tipo del documento:
Article