- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04228939
Smartphone-based Aftercare for Inpatients With Anorexia Nervosa (SMART-AN)
Therapist-guided Smartphone-based Aftercare for Inpatients With Severe Anorexia Nervosa (SMART-AN): a Randomized Controlled Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Anorexia nervosa (AN) is a severe, often chronic and life-threatening disorder. Relapse after treatment is common with relapse rates ranging between 9 and 52% and being highest within the first year following treatment particularly as early as 3 months posttreatment. Even if weight restoration is achieved, it is quite difficult for patients to sustain improvements after treatment, so aftercare and relapse prevention are essential research topics. There is a recent review on internet- and mobile-based aftercare and relapse prevention in mental disorders that concludes that there is some evidence that such interventions are feasible instruments for maintaining treatment gains for some mental disorders, including eating disorders (EDs). However, the authors claim for further high quality, large-scale trials that are needed to expand research fields. So, the aim of this study is to prove the efficacy of a guided smartphone-based aftercare intervention for inpatients with AN. Our primary hypothesis is that at the end of aftercare intervention (T1), the intervention group shows a significantly lower eating disorder symptomatology than the control group.
Eligible patients with AN who are discharged from inpatient treatment are randomized either to receive a 4-month smartphone-based aftercare intervention with therapist feedback as an add-on element to treatment as usual (TAU) or TAU alone. Assessments include structured interviews as well as online questionnaires and are taken at baseline (discharge, T0), end of the aftercare intervention (T1) as well as 6-month follow-up (T2).
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Prien am Chiemsee, Germany, 83209
- Recruiting
- Schoen Clinic Roseneck
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- primary diagnosis of AN (DSM-5: 307.1),
- sex: female,
- age: from 12 years onwards to 60 years,
- regular completion of inpatient treatment,
- at least a length of inpatient stay of 6 weeks,
- BMI at discharge at least 15, at least a 1-point BMI increase during inpatient treatment,
- owner of a smartphone,
- informed consent of the patient and, in case of minors, also of the parents.
Exclusion Criteria:
- major depression (BDI-II > 29 at discharge),
- suicidal tendency (item 9 of BDI-II > 1 at discharge),
- very high level of care after inpatient treatment (e.g. therapeutic living community, day clinic),
- pregnancy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Intervention group (IG)
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Patients randomized to IG receive a therapist-guided smartphone-based aftercare intervention for a period of 16 weeks.
The patients are invited to download for free the German version of "Recovery Record" at the App Store (iPhone) or the Google Play Store (android) to their smartphone and to link with the aftercare therapist.
After discharge, patients are asked to monitor their meals at least three times per day (breakfast, lunch, and dinner), that is, to produce a minimum of three logs per day over the subsequent 16 weeks.
Furthermore, patients are instructed to monitor their thoughts and feelings as well as their (disordered) behaviors.
The aftercare therapist also sets the patients clinical post-discharge goals and makes coping skill suggestions.
Individual therapist feedback is provided in-app twice per week during the first four weeks, once per week in weeks 4-8, every other week in weeks 8-12 and once in week 16.
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Active Comparator: Control group (CG)
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Patients randomized to CG receive TAU i.e. patients and their physicians or therapists decide on post-discharge treatment which is documented at T1 and T2.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in Eating Disorder Severity (assessor-based)
Time Frame: Measured at baseline (discharge), at week 16 (end of treatment) and 6 month follow-up
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The Eating Disorder Examination (EDE) will be used to measure asessor-based eating disorder symptom severity over time.
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Measured at baseline (discharge), at week 16 (end of treatment) and 6 month follow-up
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Changes in Body-Mass-Index (BMI)
Time Frame: Measured at baseline, week 16 and 6 month follow-up
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Weight and height will be used to measure BMI over time.
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Measured at baseline, week 16 and 6 month follow-up
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Changes in Eating Disorder Severity (self-report)
Time Frame: Measured at baseline, week 16 and 6 month follow-up
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The Eating Disorder Examination Questionnaire (EDE-Q) will be used to measure self-reported eating disorder symptom severity over time.
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Measured at baseline, week 16 and 6 month follow-up
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Changes in depressive symptoms
Time Frame: Measured at baseline, week 16 and 6 month follow-up
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The Beck Depression Inventory-II (BDI-II) will be used to measure depressive symptoms over time.
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Measured at baseline, week 16 and 6 month follow-up
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Changes in stages of change regarding specific eating disorder behaviors
Time Frame: Measured at baseline, week 16 and 6 month follow-up
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The Stages of Change Questionnaire for Eating Disorders (SOCQ-ED) will be used to measure changes in stages of change regarding specific eating disorder behaviors over time.
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Measured at baseline, week 16 and 6 month follow-up
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Changes in self-efficay
Time Frame: Measured at baseline, week 16 and 6 month follow-up
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The General Self-Efficacy Scale (GSE) will be used to measure self-efficacy over time.
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Measured at baseline, week 16 and 6 month follow-up
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Participant satisfaction with the app and the aftercare intervention
Time Frame: Measured at week 16
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A self-developed questionnaire will be used to assess self-reported satisfaction with the app and the aftercare intervention.
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Measured at week 16
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Additional outpatient and inpatient treatment after discharge
Time Frame: Measured at week 16 and 6 month follow-up
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Number and length of outpatient or inpatient treatment (rehospitalization) since discharge will be assessed.
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Measured at week 16 and 6 month follow-up
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Adherence to the smartphone-based aftercare intervention
Time Frame: Measured from baseline to week 16
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Adherence will be measured via dichotomous outcome of drop-out (individuals will be considered as drop-out if they fail to login to the app at all for a period of 14 consecutive days.
Adherence will be assessed through application usage data.
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Measured from baseline to week 16
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Adherence to self-monitoring tasks
Time Frame: Measured from baseline to week 16
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Frequency of self-monitoring entries will be tracked automatically through the program server
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Measured from baseline to week 16
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 78-17
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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