Co-developing a care pathway for patients discharged from inpatient treatment for anorexia nervosa: a case study

Abstract

Purpose The transition period from eating disorder inpatient (IP) care to outpatient care can be difficult for patients and is often characterised by high relapse rates. This study aims to co-develop a novel treatment pathway to support patients during this critical period. Design/methodology/approach This was a mixed-methods case study using co-production methodology and a nested qualitative component. The authors co-developed an initial proposed pathway structure with clinicians and people with lived experience of an eating disorder, based on a review of the literature. They then conducted interviews with clinicians and patients (n = 8) to refine the pathway; these were analysed using framework analysis. Findings A four-component pathway structure was developed. Six main themes emerged from this qualitative analysis: autonomy, the need for holistic patient care, difficult experiences, service provision, relationships and feedback on the discharge pathway. Practical implications This study highlighted the importance of centring patient autonomy during treatment, as well as ensuring treatments are holistic in nature. This may reduce the high levels of relapse associated with discharge from IP treatment and improve the quality and effectiveness of eating disorder treatment delivered. Originality/value Co-production approaches were used to develop the IP discharge pathway with members of a Lived Experience Advisory Panel alongside clinicians. To the best of the authors’ knowledge, this study was also the first intervention development study aimed at providing targeted support for patients dealing with the adverse effects of hospitalisation and difficulties transitioning to outpatient care.