CPG for Eating Disorders

1. IntroductionBackgroundThe development of the evidence-based clinical practice guideline elaboration Programmefor the NHS is being carried out 2ithin the framework of the development of the Quality Plan ofthe Ministry of Health and Consumer Affairs (MSC), through the National Health System(NHS)’s Quality Agency.In the initial phase of this Programme (2006), the development of eight CPGs has beenprioritised. A collaboration agreement has been established between the ISCIII and healthtechnology assessment agencies and units and the Iberoamerican Cochrane Centre. The HealthSciences Institute of Aragón is in charge of the Programme’s coordination activities.In the bilateral agreement between the CAHTA of Catalonia and the ISCIII it was agreed todevelop a CPG for eating disorders: anorexia nervosa (AN), bulimia nervosa (BN) and atypicalor unspecified eating disorders (EDNOS), based on the best scientific evidence available, whichwould address the most important areas for the NHS, in a coordinated manner and with sharedmethodology which would be determined by a group of NHS professionals experienced in CPGdevelopment. These professionals have comprised the methodological group and the panel ofcollaborators of the CPG development programme (1) .JustificationIn the last decades, eating disorders have gained increasing sociosanitary relevance due totheir severity, complexity and difficulty in establishing a diagnosis and specific treatment.Eating disorders are pathologies of multifactorial ethiology where genetic, biological,personality, family and sociocultural factors converge, affecting mainly children, adolescentsand young adults.There are is no data available in Spain that analyses the economic burden of eatingdisorder treatments nor studies that assess the cost-effectiveness of different treatments.However, different studies conducted in countries of the European Union 2-7 indicate that directcosts (diagnosis, treatment and monitoring or follow-up) and especially indirect costs (economiclosses derived from the disease that impact the patient and his/her social setting) entail a higheconomic burden and considerably decrease the quality of life of patients with eating disorders.According to a German study that was carried out in 2002, in the case of AN, averagehospitalisation cost is 3.5 times higher than the general hospitalisation average 4 .(1)N= 2,188 AN discharges, recorded during 2003 and 2004 in 156 health areas of 15 autonomous communities.CLINICAL PRACTICE GUIDELINE FOR EATING DISORDERS33