Fellow Cohen Children's Medical Center Lake Success, New York, United States
Background: Eating disorder (ED) diagnoses, hospitalizations, and the use of telehealth rose substantially during the COVID-19 pandemic. This resulted in many adolescents with EDs receiving care via telehealth rather than in-person. Objective: The aim of our study was to determine if adolescents with EDs and/or their parents/guardians found telehealth visits to be an acceptable alternative to in-person visits with respect to outpatient ED care. We were particularly interested in how age and/or past experience with office visits might affect responses. Design/Methods: This was an IRB-approved, single site, cross-sectional study using an online survey for data collection. Potential participants included any patient who had an ED-related telehealth visit with our division between April 1, 2020, and October 31, 2021. The survey explored ED diagnosis and behaviors, experience with in-person visits, access to technology needed for telehealth, and experience with ED telehealth visits. Participants were invited to complete the survey via email using REDCap. 617 invitations were sent. 50 surveys were completed. Fisher’s exact tests were performed to determine if age and/or past experience with in-person visits influenced responses to questions about satisfaction with telehealth, likelihood of participating in future telehealth visits, and preference for in-person vs. telehealth ED visits. Results: The most common ED diagnosis of respondents was anorexia nervosa/atypical anorexia nervosa (56%). Most respondents reported worsening of ED thoughts (54%), food restriction (62%), anxiety (72%), and mood (70%) during the pandemic. Less than half reported pre-pandemic experience with teleconferencing (40%) or telehealth (14%). Most preferred in-person visits for ED care (60%). A similar majority (60%) felt they would be somewhat or very likely to participate in future telehealth encounters with adolescent medicine. 50% somewhat/strongly agreed that “telehealth improves my access to eating disorder outpatient treatment services”. 62% somewhat/strongly agreed that telehealth was an acceptable way to receive healthcare services. There were no statistically significant differences in responses when participants were compared by age or history of in-person visits.
Conclusion(s): While most respondents preferred in-person to telehealth visits for ED care, most also found telehealth to be an acceptable way to receive healthcare services and would be willing to participate in future telehealth encounters. For underserved populations, telehealth services for ED outpatient treatment could improve access to adolescent medicine specialists.
