PMH11 - E-THERAPIES IN PREVENTING AND TREATING EATING DISORDERS: REVIEW OF TRIALS AND REAL-WORLD EVIDENCE

Abstract

Eating disorders affect 2-4% of young adults. Technology in healthcare is changing treatment delivery. Previous meta-analysis of clinical trials have demonstrated promising, but inconclusive results of online and app-based interventions (e-therapies), urging improved methods in future trials. Uncertainty also exists about effectiveness in real-world settings. Objectives of this review are to identify and review recent comparative trials and real-world evidence (RWE) assessing efficacy/effectiveness of e-health technologies in preventing and treating eating disorder. A previous systematic literature review (SLR) of e-therapies in eating disorder captured relevant trials published prior to July 2014. Additional searches were run on Medline, Embase and trial registries to identify trials since 2014 and all RWE from database inception until June 2018. Studies assessing efficacy/effectiveness of e-therapies versus other or no therapy were included. We also ran targeted searches to identify trials including therapist, which were excluded from previous SLR. Eighteen additional trials were included but no RWE was identified. Internet-based interventions were the most commonly evaluated therapies but the search identified little evidence from single studies on smartphone applications, telemedicine, text messaging and video therapies. Most studies comparing internet-based therapies to waiting lists showed reduction in eating disorder symptoms and improvement on eating disorder scales. Majority of the studies comparing internet-based (mostly therapist-led interventions) or chat to face-to-face therapies reported similar efficacy. Limited evidence was identified comparing therapist-involved therapies (i.e., video therapies, text messaging, email therapies, telemedicine) and non-therapist involved smartphone applications with face-to-face or waiting lists. Similar to previous SLR, recent trials showed efficacy of internet-based interventions versus waitlist, but similar efficacy to face-to-face therapy. Potential cost-savings with internet-based interventions versus face-to-face therapies, given the similar efficacy, is yet to be determined. Further research is required to assess effectiveness of e-therapies in real-life settings in treating and preventing eating disorders.