Primary care treatment of eating disorders: from diagnosis to referral
Currin, L. G. London, King’s College Ph.D. 2006 G6s 56-9781
General practitioners (GPs) have a key role in the early management of eating disorders but also act as gate-keepers for access to specialist care. Despite this key role, research on eating disorders in primary care is limited.
METHOD: A variety of designs and methods were employed to address: the epidemiology of eating disorders in primary care; current treatment practices in relation to published guidelines; predictors of variability in treatment behaviour; and different perspectives of primary care treatment.
RESULTS: A national database was used to study recorded cases of anorexia and bulimia nervosa. Annual incidence rates were calculated for the years between 1994 and 2000 and compared with previously published figures. While the incidence of anorexia nervosa was stable over the period studied, there were significant fluctuations in the incidence of bulimia nervosa.
A cohort of primary care clinicians in a defined region (population of 6.4 million) participated in a survey of treatment behaviour for patients with eating disorders. There was considerable variability in practice, and little concordance with the recommendations in published guidance.
To determine the influence of patient and clinical variables on treatment behaviour, vignettes were presented to 150 GPs from diverse regions. The gender of the case vignettes influenced treatment decision, as did professional knowledge and attitude towards eating disorders.