A Randomised Controlled Multi-Centre Open-Label Parallel Group Non-Inferiority Trial of the Clinical Effectiveness, Acceptability and Cost-Effectiveness of a ‘Stepping into Day Treatment’ Approach versus Inpatient Treatment as Usual for Anorexia Nervosa in Adult Specialist Eating Disorder Services (DAISIES)

DAISIES will investigate the clinical effectiveness, acceptability, and cost-effectiveness of a stepped care approach compared to inpatient treatment as usual for adults with severe anorexia nervosa. The stepped care approach will involve a brief inpatient stay if necessary, then day-patient treatment for the remainder of the treatment episode.

Qualitative interviews with past patients and clinicians to understand their experience of inpatient and day-patient treatment will help to support the delivery of the stepped care approach and optimise trial recruitment and retention.

A qualitative process evaluation will also be conducted to investigate views on treatment and how it produced change from the perspective of patients, families and clinicians. Patients and caregivers in each arm will be interviewed to understand their experience of treatment and the perceived benefits and effects of each treatment mode. Additionally, staff and clinicians across treatment setting will be interviewed to help us understand the advantages and disadvantages of providing treatment in each trial arm, and to understand the challenges associated with delivering treatment in these settings to contextualise the trial outcomes.