Can Home Nocturnal Tube Feeding Be Used Successfully In Anorexic Patients

Abstract LEARNING OUTCOME: To describe how home nocturnal tube feeding can be used to supplement food intake in young patients with anorexia nervosa. Rising inpatient costs lead clinicians to find effective nutritional management practices that can be continued at home. Due to the nature of the disease, anorexia nervosa and some other eating disorder conditions, it was not a general practice to try home tube feeding. However, long hospitalization itself can have detrimental effects to the patient, such as alienation and isolation from the family. A home nocturnal tube feeding pilot program was successfully offered to selected inpatients (n=5, 10-16 years old) as an alternative to inpatient care. A visiting nurse was available to assist the patient to set up overnight feeding and support. The overnight feeds were usually set up by 8.30 PM and run until 6.30 AM. A 1.5 kcal/ml commercially available product was generally used. Telephone contact with the psychiatric case manager, dietitian and physician was also encouraged. Careful selection criteria for patients trying this method is necessary. The patients'family situations varied from very supportive, to detached, to ward of the state. Patients themselves generally wanted to be out of hospital but some were not highly motivated to improve health status. None of the patients were known bulimic. One of the aims of this program was to avoid contact with patients with similar conditions, as this often had a negative impact. Frequent outpatient appointments were put in place, i.e. initially once a week and then fortnightly to a multidisciplinary Eating Disorders Clinic which includes a physician, a psychiatrist and a dietitian. The major aim of keeping the client medically safe and thus able to stay outside the hospital was achieved, and nutritional rehabilitation was achieved and maintained.