Adherence of psychopharmacological prescriptions to clinical practice guidelines in patients with eating behavior disorders

Pardo, María del Mar Alañón; Martín, Mónica Ferrit; Hernández, Miguel Ángel Calleja; Márquez, Fernando José

doi:10.1007/s00228-017-2287-2

Cited by 14 publications

(7 citation statements)

References 30 publications

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“…Our data tend to show that although the above may be considered a more than desirable objective for ED specialist care, a rapid and efficient referral to specialist ED care is probably a result we still have to achieve, at least under routine clinical practice conditions in Italy. However, our data are in line with the recent international observations concerning the lack of dissemination, the unsatisfactory implementation, and the low adherence to the recommendations provided by major international guidelines for EDs in clinical practice (Hilbert, Hoek, & Schmidt, ; AlañónPardo, Ferrit Martín, Calleja Hernández, & MorillasMárquez, ).…”

Section: Discussionsupporting

confidence: 90%

Pathways to specialist care for eating disorders: An Italian multicentre study

Volpe

Monteleone

Ricca

et al. 2019

Euro Eating Disorders Rev

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Two hundred forty six patients with eating disorders (EDs) recruited from eight Italian specialized treatment centres were administered with the World Health Organization “Encounter Form,” a standardized schedule that makes it possible to characterize the clinical pathways that patients follow to reach specialized care. The median time from symptoms onset to specialized care was 114 weeks. Primary “points of access to care” were general practitioners (25%), psychiatrists (18%), and clinical nutritionists (17%), followed by various other carers. All patients received specific psychotherapy, whereas only 11% of them were given psychotropic drugs. EDs are characterized by complex care pathways, with low rates of direct access to specialized care. Although the role of general practitioners remains crucial, they tend to follow different clinical routes to refer ED patients. Educational programmes on EDs should be addressed to general practitioners and clinical nutritionists, in order to ease the transition of ED patients to a mental health care setting.

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Section: Discussionsupporting

confidence: 90%

Pathways to specialist care for eating disorders: An Italian multicentre study

Volpe

Monteleone

Ricca

et al. 2019

Euro Eating Disorders Rev

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“…Several previous studies have found that ED patients show nonadherence to treatment or routine medical checkups. Therefore, the nonadherence could result in a delay in the early detection or treatment of cancers (Alanon Pardo, Ferrit Martin, Calleja Hernandez, & Morillas Marquez, 2017; Gatt et al, 2014). Several studies have shown that the patients with ED are at the risk of alcohol usage disorder, which in turn is associated with the risk of esophageal, stomach, or even other site cancers.…”

Section: Discussionmentioning

confidence: 99%

Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

Yeh

Chien

Chung

et al. 2020

Intl J Eating Disorders

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Background: Previous studies have shown elevated cancer risk in anorexia nervosa but the literature on other eating disorders (EDs) is scarce. This study aimed to investigate the association between all EDs and esophageal, stomach, and other cancers.Methods: We used a retrospective cohort design, based on a two-million randomized longitudinal health insurance dataset, a sub-dataset of Taiwan's National Health Insurance Research Database. From all the potential participants aged 20 years or more, a total of 6,628 participants were enrolled, including 1,657 patients with EDs, with sex-, age-, and indexed date-matched (1:3) 4,971 controls. Each participant was individually tracked from 2000 to 2015 to identify incident cases of cancers, including esophageal cancer (EC), stomach cancer (SC), and all other cancers (AOC). The multivariate Cox proportional hazards model was employed to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between EDs and cancer.Results: Of the total 6,628 enrollees, 222 in 1,657 individuals with EDs and 810 in the 4,971 non-ED control individuals developed cancer (1,262.40 vs. 1,472.15 per 100,000 person-years), and the Kaplan-Meier survival analysis was not statistically significant (log-rank, p = .324). However, after adjusting for covariates, the risk of EC and SC among the individuals with an ED was significantly higher, with adjusted HRs of 5.32 (95% CI: 1.07-26.49, p < .001) and 4.61 (95% CI: 1.91-11.14, p < .001), respectively. EDs were not associated with other cancers. Conclusions:This study provides evidence for the association between EDs and the risk for EC and SC. Further research on mechanisms and prevention is therefore needed.

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“…Also, dangerous drugs such as bupropion or tricyclics, are still prescribed despite the conclusions of the literature [7]. The same observation has been made in other studies on adults and adolescents in different countries [7,8,192]. These papers highlight the disparity between research conclusions and clinical practice in the treatment of AN.…”

Section: Discussionmentioning

confidence: 87%

“…In 2011 the World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of eating disorders [6] concluded that the majority of the drugs to treat AN are used off-label [6]. These drugs are widely prescribed, but not in compliance with international guidelines [7,8], and can therefore be potentially unsafe for patients with AN.…”

Section: Introductionmentioning

confidence: 99%

Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews

Blanchet

Guillaume

Bat-Pitault

et al. 2019

JCM

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Drugs are widely prescribed for anorexia nervosa in the nutritional, somatic, and psychiatric fields. There is no systematic overview in the literature, which simultaneously covers all these types of medication. The main aims of this paper are (1) to offer clinicians an overview of the evidence-based data in the literature concerning the medication (psychotropic drugs and medication for somatic and nutritional complications) in the field of anorexia nervosa since the 1960s, (2) to draw practical conclusions for everyday practise and future research. Searches were performed on three online databases, namely MEDLINE, Epistemonikos and Web of Science. Papers published between September 2011 and January 2019 were considered. Evidence-based data were identified from meta-analyses, if there were none, from systematic reviews, and otherwise from trials (randomized or if not open-label studies). Evidence-based results are scarce. No psychotropic medication has proved efficacious in terms of weight gain, and there is only weak data suggesting it can alleviate certain psychiatric symptoms. Concerning nutritional and somatic conditions, while there is no specific, approved medication, it seems essential not to neglect the interest of innovative therapeutic strategies to treat multi-organic comorbidities. In the final section we discuss how to use these medications in the overall approach to the treatment of anorexia nervosa.

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Adherence of psychopharmacological prescriptions to clinical practice guidelines in patients with eating behavior disorders

Cited by 14 publications

References 30 publications

Pathways to specialist care for eating disorders: An Italian multicentre study

Pathways to specialist care for eating disorders: An Italian multicentre study

Eating disorders and the risk of esophageal and stomach cancers‐A nationwide, population‐based cohort study in Taiwan

Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews

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