Dossier n. 240/2014 [Abstract] Regional program on eating disorders: contributions 2009-2012

This report collects the contributions of the Regional task force on Eating Disorders (ED), aimed at providing useful tools for the organization and planning of clinical pathways for people with ED. This was part of the ED Program of care 2009-2011 in Emilia-Romagna (Regional Act 1298/2009).

The Regional task force, created in 2010, supported and facilitated the constitution of the Regional network for EDs, focusing on health promotion in childhood and continuity of care across services for different age groups. The activity of the task force was divided into three sub-groups, each one dealing with a specific topic of the ED Regional Program. The three chapters of this report summarize the main issues.

The first chapter provides an organizational analysis, in order to assess the adherence of each Health Trust to the recommendations of the Regional Program. This analysis is also aimed at highlighting the advantages of the different organizational models adopted. The most promising model to date seems to be a network of various professionals (multidisciplinary approach), providing continuity of care based on increasing levels of treatment (outpatient, day hospital, inpatient, long-term residential care).

Chapters 2 and 3 give detailed and up-to-date strategies in the assessment and treatment of the acute phase of ED by age groups (minors and adults). In particular, the second chapter raises issues relating to the treatment and rehabilitation of ED in the specific context of childhood and adolescence. The chapter encompasses clinical aspects and indications on organizational procedures recommended by international guidelines both in the assessment and treatment phase of minors with ED. In addition, it highlights the specific characteristics of treating minors and clarifies the relationships across the different levels of care. In this regard, given the particular risks of chronicity and complications, the report emphasizes the need to pay special attention to prevention in selected populations and to provide early diagnosis in childhood.

Finally, the third chapter presents criteria and guidelines for admissions in case of metabolic emergencies. Along with the description of the current situation of ED admissions in Emilia-Romagna, it is recommended to identify a Medical Unit for each Health Trust or at least a Pediatrics Unit for each one of the three large sub-regional areas. In addition to medical indications for admissions, functional standards and staff requirement for appropriate inpatient care are also detailed. In conclusion, the chapter outlines aims of hospital admissions, nutritional rehabilitation systems suitable for each stage of treatment, issues concerning the duration of hospitalization and procedures of discharge.