(P26-018-23) The Graz Model and Its Interprofessional Focus: An Innovative Telehealth Method for Transitioning Children off Feeding Tubes

Objectives: Families with a tube-fed child are at risk for isolation, increased stress, and decreased quality of life (Russell et al., 2018). While most return to oral feeding once their medical situation is resolved, many children develop tube dependency and cannot accomplish this task without intervention. Research has shown that an interdisciplinary approach to tube weaning increases efficacy, positively affecting health outcomes (Sharp et al., 2017; Gardiner et al., 2017). However, families often lack access to tube-weaning support, and the strategies offered often fail to keep the broader feeding context in mind. The “Graz model of tube weaning” (Marinschek et al.,2020) attempts to bridge this gap by treating the whole family unit as integral to the process.

Methods: The team is comprised of pediatricians, psychologists, and feeding therapists, with components of each discipline integrated into the two main principles of the “Graz model of tube weaning:” 1. Enable the child to feel hunger 2. Enable the child’s sense of autonomy and encourage self-directed oral intake (Marinschek et al.,2020). Allowing the child to experience sensations related to appetite is essential to the process and must be carefully supervised. Particular attention is given to weight management and caregiver education on early hunger signs via daily telehealth communication and video analysis. Emphasizing the development of a child’s feeding autonomy requires careful guidance from all team members. Due to the increased risk for children on feeding tubes developing severe avoidance and refusal patterns, feeding and eating techniques must be scaled back to empower the child.

Results: Results from a recent outcome study (N=834) where 91.7% of participants completed the telehealth program between 2009 and 2022 showed that 97.4% of them were fully tube weaned, with 2.6% partially tube weaned. The median age of child completing the program was 1.6 years (SD=18.73). The most common diagnostic groups represented (n=208) were prematurity and cardiac diagnoses (n=105).

Conclusions: The “Graz Model of Tube Weaning” as an effective, interdisciplinary model to address the transition from enteral to oral nutrition. Not only is this approach successful in a telehealth context, this format also increases access for families that may otherwise lack therapeutic support.

Funding Sources: No funding source