Abstract
PurposeEating disorders (EDs) is a major health condition affecting 9% of the global population and 10% of those with EDs lost their lives as a result. Text-based telehealth interventions (TTIs) seem to provide a low-cost and convenient treatment option; however, the evidence is scarce. This study aimed to synthesize evidence relating to the use of TTIs for the management of EDs.Design/methodology/approachFive databases were searched published between January 2020 and May 2019. The authors used keywords relating to telehealth and EDs. The authors used Joanna Briggs Institute's (JBI's) critical appraisal instrument to assess the methodology quality of included studies.FindingsFifteen studies were included in this mix-method systematic review and assessed for methodology quality. Email, web-based texting, text-messaging and online chat room were used as mode for deliver healthcare for patients with EDs. In the treatment phase, all studies (nine studies; n = 860 participants) showed effectiveness (for RCTs) and usefulness (for non-RCT studies). In the aftercare phase (six studies; n = 364 participants), the results regarding the effectiveness of TTIs were mixed. Two studies showed effectiveness whilst four studies did not find statistically significant change of ED outcomes.Research limitations/implicationsThe qualities of these studies varied; firstly, 66% (n = 10) of the studies were non-randomized studies (e.g. single-arm trial, case report) with small samples. Moreover, one-fourth (n = 4) of the studies did not use validated instruments or indicate the instrument. Also, half (n = 7) of the studies used TTIs as adjunct to face-to-face treatment or bigger online treatment, it is hard to make conclusion that the changes were due to TTIs' effect. In addition, follow-up rate is not satisfactory, thus results should be interpreted cautiously.Practical implicationsTTIs seem to be promising for management of EDs, particularly in the treatment phase. This provides an important treatment option for health practitioners and people with EDs as an alternative or in adjunct with face-to-face services.Originality/valueThis is the first review to synthesis the use of TTIs for ED management.
Highlights
Eating disorders (EDs) include a range of health issues characterized by a persistent disturbance of eating or eating-related behaviors resulting in the altered consumption or absorption of food [1]
We used this combination of search terms: AND (“eating disorder” OR “eating disorders” OR bulimi* OR anorexi* OR binge eat* OR eating disorder not otherwise specified (EDNOS)) (Appendix 1)
For randomized controlled trials (Table 3), we found that the quality of evidence for three studies were “good” and two were “moderate.” For quasi-experimental studies (Table 4), quality assessment showed that five studies were categorized into “good” quality, while two were “moderate.” Because six out of seven quasi-experimental studies were single-arm trial, none of them had control group
Summary
Eating disorders (EDs) include a range of health issues characterized by a persistent disturbance of eating or eating-related behaviors resulting in the altered consumption or absorption of food [1]. This is a major health problem that requires high utilization of health services and medical attention. ED patients often show significant social isolation, poor quality of life, poor academic performance and higher rates of substance abuse Recovery rates for those who receive treatments for EDs are reportedly low, and the relapse rates are high [10,11,12]. Mortality rates for individuals with EDs are about twice as high as people without Eds [13]
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