Impact of patient characteristics on clinicians' decisions to involve dietitians in eating disorder treatment

Background Dietetic involvement in eating disorder (ED) treatment is often initiated by other members of a patient's treating team. The present study aimed to examine the impact of patient characteristics on clinicians' decisions to involve a dietitian in a patient's ED treatment, as well as the influence of clinician characteristics on their decision‐making. Methods ED clinicians were recruited to complete an online survey, which used case vignettes to assess their likelihood of referring patients to a dietitian or consulting with a dietitian for guidance. Questions were also included that measured clinician anxiety, beliefs about the therapy they deliver, beliefs about dietitians and views on evidence‐based practice to determine whether these were related to their responses to case vignettes. Results Fifty‐seven clinicians completed the survey, with the largest group being clinical psychologists (n = 22, 39%). ED diagnosis, weight status, medical co‐morbidities and progress in treatment were all shown to be influential on whether clinicians involved dietitians in ED treatment. Clinician characteristics and their beliefs about dietitians were generally not correlated with the likelihood of seeking dietetic input. Conclusions The present study indicates that clinicians' decisions to involve dietitians in ED treatment are systematic rather than random decisions influenced by individual clinician characteristics. Clinicians require further education on the potential for malnutrition regardless of patients' ED diagnosis or weight status, and the dietitian's role in addressing this. Key points Clinicians’ decisions to involve dietitians in eating disorder treatment are influenced by a patient's eating disorder diagnosis, weight status, presence of medical co‐morbidities and progress in treatment. Clinician characteristics (anxiety, beliefs about their own therapy, beliefs about dietitians, views on evidence‐based practice) were not correlated with their decision to involve dietitians in treatment. It is recommended that the potential for malnutrition regardless of patient's weight status receives greater attention, and that further clarity around dietitians’ roles and responsibilities in eating disorder treatment is developed.