Table 48.
Meal support during inpatient treatment versus no meal support be used in the treatment of children and adolescents with eating disorders
| Certainty assessment | Impact | Certainty | Importance | ||||||
|---|---|---|---|---|---|---|---|---|---|
| № of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | |||
| Rate of Weight Gain (assessed with: Measures of Weight Gain in Kg/Day), Need for NGT Feeds (assessed with: # of Patients Receiving NGT Feeds) | |||||||||
| 3 | Case Control | serious a | serious b | not serious | serious c | all plausible residual confounding would reduce the demonstrated effect | Three studies examined the effect of meal support/supervision as part of inpatient treatment for a total number of patients receiving meal support of 88 patients. There were no significant differences between cohorts who received meal support and those who did not on the rate of weight gain per day or week,although there was a trend towards greater weight gain /day or week in the group who received meal support. Weight gain varied from 0.09 kg/day to 0.35 kg/day across studies. |
⨁◯◯◯ VERY LOW |
CRITICAL |
| serious d | not serious | not serious | not serious | strong association all plausible residual confounding would reduce the demonstrated effect | One study of these studies reported on difference in the rate of NGT feeds in cohort of patients treated on inpatient unit before the institution of consistent meal support vs after. 8/12 patients not receiving meal support (ie 66.7%) and 1/9 (11.1%) of those receiving meal support required NGT feeds as part of inpatient admission. |
⨁⨁⨁◯ MODERATE |
IMPORTANT | ||
Explanations
aDifferences in LOS and age between those receiving meal support and those not receiving meal support may have affected outcomes
bWide variation in # of meals/day supervised between various studies
cWide confidence intervals in some studies/groups
dCriteria for initiating NGT feeds somewhat vague (ie “consistent failure” to meet expected weight gain and/or acute refusal of food
Bibliography:
Case Control - Kells 2013 [239], Kells 2017 [240], Couturier 2009 [238]