TY - JOUR
T1 - Understanding non-routine discharge
T2 - Factors that are associated with premature termination from higher levels of care in adults with anorexia nervosa
AU - Gorrell, Sasha
AU - Rienecke, Renee D.
AU - Duffy, Alan
AU - Huston, Emma
AU - Mehler, Philip S.
AU - Johnson, Craig
AU - Manwaring, Jamie
AU - McClanahan, Susan
AU - Blalock, Dan V.
AU - Le Grange, Daniel
N1 - Funding Information:
This research received no specific grant from any funding agency, commercial or not-for-profit sectors. Dr. Gorrell is supported by the National Institute of Mental Health (K23MH126201).
Publisher Copyright:
© 2022 Taylor & Francis.
PY - 2022
Y1 - 2022
N2 - This study sought to replicate and extend associations between clinical and demographic features at admission and types of premature treatment termination for adults diagnosed with anorexia nervosa (AN) in higher-level-of-care settings. Secondary data analyses examined a study population comprised of adults with AN (N = 565) who were admitted to one of two United States eating disorder treatment centers (April 2015–April 2020) for intensive outpatient, partial hospitalization, residential, or inpatient services. There were no significant differences in the type of non-routine discharge according to level of care. At admission, those with lower BMI were more likely to discharge against medical advice, and those with lower cognitive restraint and elevated binge eating were more likely to discharge against medical advice or by staff-initiated request, respectively. Discharge by parent/patient request was more likely among those who were older or who reported lower baseline desire for muscularity. Overall older age, elevated binge eating, and lower weight, desire for muscularity, and cognitive restraint may be associated with less tolerance/acceptability for AN treatment. Increased understanding of how to better support patients who admit to higher levels of care with these clinical features will contribute to better odds of completion of a full course of treatment.
AB - This study sought to replicate and extend associations between clinical and demographic features at admission and types of premature treatment termination for adults diagnosed with anorexia nervosa (AN) in higher-level-of-care settings. Secondary data analyses examined a study population comprised of adults with AN (N = 565) who were admitted to one of two United States eating disorder treatment centers (April 2015–April 2020) for intensive outpatient, partial hospitalization, residential, or inpatient services. There were no significant differences in the type of non-routine discharge according to level of care. At admission, those with lower BMI were more likely to discharge against medical advice, and those with lower cognitive restraint and elevated binge eating were more likely to discharge against medical advice or by staff-initiated request, respectively. Discharge by parent/patient request was more likely among those who were older or who reported lower baseline desire for muscularity. Overall older age, elevated binge eating, and lower weight, desire for muscularity, and cognitive restraint may be associated with less tolerance/acceptability for AN treatment. Increased understanding of how to better support patients who admit to higher levels of care with these clinical features will contribute to better odds of completion of a full course of treatment.
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U2 - 10.1080/10640266.2021.2011648
DO - 10.1080/10640266.2021.2011648
M3 - Article
C2 - 35175902
AN - SCOPUS:85125298376
SN - 1064-0266
VL - 30
SP - 686
EP - 699
JO - Eating Disorders
JF - Eating Disorders
IS - 6
ER -