Certainty assessment | Impact | Certainty | Importance | ||||||
---|---|---|---|---|---|---|---|---|---|
№ of studies | Study design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | |||
Outcomes: Expressed emotion scale; ED symptom impact scale | |||||||||
1 | randomised trials | not serious | not serious | not serious | not serious | none | 1 RCT with caregivers (n = 134 in telephone coaching ECHO intervention; n = 134 control) for individuals with AN [79]. Caregivers in the intervention group had reduced expressed emotion levels at patient discharge and 6-month follow-up. | ⨁⨁⨁⨁ HIGH | CRITICAL |
Caregivers in the telephone coaching intervention group experienced greater reductions in ED symptom impact scale scores than in the control group [79]. | |||||||||
1 | randomised trials | not serious | not serious | not serious | not serious | none | 1 pilot RCT with caregivers for individuals with AN (n = 33 in OAO web-based intervention; n = 30 in telephone and email hotline control) [113]. Compared with control, the OAO intervention significantly reduced anxiety and depression in caregivers at post-treatment; caregivers in the OAO intervention had greater reductions in expressed emotion than controls, but these were not significant. | ⨁⨁⨁⨁ HIGH | CRITICAL |
Similar to expressed emotion, caregivers’ ED symptom impact scale scores were also reduced across both groups, but there was no significant difference between groups [113]. | |||||||||
1 | randomised trials | not serious | not serious | not serious | not serious | none | 1 feasibility RCT with caregivers for individuals with AN (n = 19 OAO + guidance intervention; n = 18 OAO only) [114]. Levels of expressed emotion reported by caregivers at post-intervention were reduced but did not differ significantly between the groups. Those with AN did not perceive that their caregivers’ levels of expressed emotion had significantly changed. | ⨁⨁⨁⨁ HIGH | CRITICAL |
Caregivers’ ED symptom impact scale scores were also reduced across both groups, but there was no significant difference between groups [114]. |