Digital guided self-help for binge eating disorder: Devising an effectiveness study and testing its acceptability and feasibility

Digital guided self-help for binge eating disorder: Devising an effectiveness study and testing its acceptability and feasibility Background Binge Eating Disorder (BED) is a common psychiatric disorder associated with significant psychological, physical and social morbidity. It tends to run a chronic course.

Its prevalence is estimated as 3.2% of the population aged 16-years or over, equivalent to about 1.4 million sufferers in England. The NICE guidelines recommend a stepped care approach to the management of BED.

The first step is 'Guided Self-Help' (GSH) in which the individual follows a self-help programme with guidance from a non-specialist. Conventionally, the programme is printed. I have led the development of a digital programme; one that can be used via a mobile application or the internet. It has been directly derived from the leading, NICE-endorsed, face-to-face psychological treatment for BED.

This sophisticated digital programme, capable of personalising the treatment to match important details of an individual's eating disorder, is likely to enhance the potency and accessibility of GSH. A proof-of-concept study of this digital programme has shown that it is well accepted and can have a major impact.

It requires definitive evaluation to establish its clinical and cost effectiveness. First, preparatory research is needed to optimise the design and implementation of the future clinical trial. The proposed research is concerned with such preparatory work. The findings will also have relevance for researchers considering the feasibility of similar interventions and trials.

People with binge eating disorder were involved in the development of the treatment and this research proposal.

Aims To evaluate the acceptability and feasibility of a randomised controlled trial (RCT) designed to assess the clinical and cost-effectiveness of the new Digital GSH programme for BED.

Key aspects of the future definitive RCT will be investigated; namely, recruitment, outcome measures, assessments, treatment uptake and completion, and PPI.

On completion, it will be decided whether it is appropriate to progress to a definitive trial and, if so, how best to optimise its design and implementation.

Plan of investigation Phase One - A systematic review and meta-analysis of existing controlled studies of digital treatments for BED will be conducted. This review will inform major aspects of the future trial; including outcomes, recruitment strategy and assessment.

Phase Two - Three focus groups with stakeholders (people with BED, primary care health practitioners, and eating disorder professionals) will be undertaken to obtain their perspectives on what can be done to ensure the success and relevance of the full trial.

Phase Three - A feasibility RCT comparing Digital GSH with conventional Printed GSH, with a nested qualitative study, will be undertaken. PPI members will be involved in each phase and in the dissemination of findings.

Potential benefits Digitalising GSH for BED is likely to improve access to this NICE-endorsed treatment, as well as enhancing its clinical and cost effectiveness. This will shorten the course of the eating disorder, thereby reducing the suffering of patients and costs to the NHS.