A multicentre randomised controlled trial to examine whether the addition of a patient and carer skill sharing intervention improves long-term patient wellbeing following hospital treatment for anorexia nervosa.


Study ID: 33131
Short Title: TRIANGLE: A novel patient and carer intervention for Anorexia Nervosa
Organisation: Dorset Healthcare University NHS Foundation Trust
Location: Dorset Healthcare University NHS Foundation Trust
Condition: Mental Health
Main Specialty: Mental Health
Expected End Date: 01/03/2019
Postcode: BH1 4JQ
Contact Name: DHUFT Research & Development
Contact Email: dhc.research&development@nhs.net
Active: Yes

Inclusion Criteria

The inclusion criteria for participants are as follows:


Consecutive admissions for in/day patient care: (a) Aged 17 or over; (b) With a DSM-5 diagnosis of Anorexia Nervosa with a body mass index (BMI) of < 18.5 kg/m2; (c) With a carer willing to participate. We will use a broad definition of “carer” to include family and/or friends willing and able to provide some aftercare support; (d) Recruited within 1 month from admission.

Exclusion Criteria

Participants are excluded from participation in this trial if:


a) The patient has an insufficient knowledge of English; b) The patient has severe mental or chronic physical illness needing treatment in its own right (e.g. psychosis, diabetes mellitus, cystic fibrosis etc.); c) The patient is pregnant; d) The dyad has previously received treatments involving the ECHOMANTRA materials [e.g. as part of iMANTRA trial (patient) or CASIS study (ECHO caregiver)]. e) The carer does not agree to participate.

Study summary:

Background: The length of stay and the mortality rate in the year after admission for patients with severe anorexia nervosa is higher than for other psychiatric conditions. We have found that actively involving the family in shared management reduces the readmission rate and improves both patient and family well being. Aim: The aim of this study is examine whether adding self management materials for carers and patients improves both patient and carer outcomes and service use in the year following specialist inpatient treatment for patients with severe anorexia nervosa. Setting. This is a multicentre study set in the NHS and independent eating disorder inpatient centres in the UK. Participants are people with anorexia nervosa age 17 and above admitted for inpatient care or daycare and their carers. Comparison: Patients and carers are randomised to treatment as usual alone or with the addition of the self management materials. Intervention: The intervention involves access to self management tools, which support the individual and the family. These contain workbooks, DVD, vodcasts and instant messages and e mail support from a mentor. Patients’ and carers’ wellbeing are measured on admission and at regular intervals over the following 18 months using questionnaires and interviews. In addition, service use, costs, and the role of prospective mediators and moderators of clinical outcomes are measured.


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