title: Technology-enhanced maintenance of treatment gains in eating disorders: efficacy of an intervention delivered via text messaging.
abstract: OBJECTIVE
  Given the lack of maintenance interventions for eating disorders, a program delivered via the short message service (SMS) and text messaging was developed to support patients after their discharge from inpatient treatment.
  
  
  METHODS
  The efficacy of the intervention was studied in a randomized controlled trial. Additionally, its impact on the utilization of outpatient treatment during follow-up was investigated. One hundred sixty-five female patients with bulimia nervosa or a related eating disorder not otherwise specified were randomly assigned to a control group (treatment as usual; TAU) or an intervention group (SMS-based maintenance intervention; SMS). After hospital discharge, participants in the intervention group submitted a weekly symptom report via text message for 16 weeks and received tailored feedback. Primary outcome was the rate of partial remission 8 months after discharge from inpatient treatment.
  
  
  RESULTS
  The difference in remission rates reached significance in the intent-to-treat analyses (SMS = 51.2%; TAU = 36.1%), χ²(1) = 3.81, p = .05, and approached significance in the completer analysis (SMS = 59.2%; TAU = 43.5%), χ²(1) = 3.44, p = .06. There were no differences in the utilization of outpatient treatment. Remission rates between the intervention and control groups were not significantly different among patients who used outpatient treatment (63.2% vs. 55.6%), χ²(1) = 0.44, p = .51. A significant difference was found in those who did not utilize such treatment (54.5% vs. 30.3%), χ²(1) = 3.97, p = .046.
  
  
  CONCLUSIONS
  The aftercare intervention was efficacious in enhancing treatment outcome after discharge from inpatient treatment.
authors.affiliation: Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany. stephanie.bauer@med.uni-heidelberg.de
authors.forename: Stephanie
authors.initials: S
authors.lastname: Bauer
authors.forename: Eberhard
authors.initials: E
authors.lastname: Okon
authors.forename: Rolf
authors.initials: R
authors.lastname: Meermann
authors.forename: Hans
authors.initials: H
authors.lastname: Kordy
mesh_terms: D000328:Adult; D000359:Aftercare; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D019114:Remote Consultation; D060145:Text Messaging; D016896:Treatment Outcome