title: Structured patient-clinician communication and 1-year outcome in community mental healthcare: cluster randomised controlled trial.
abstract: BACKGROUND
  Patient-clinician communication is central to mental healthcare but neglected in research.
  
  
  OBJECTIVE
  To test a new computer-mediated intervention structuring patient-clinician dialogue (DIALOG) focusing on patients' quality of life and needs for care.
  
  
  METHODS
  In a cluster randomised controlled trial, 134 keyworkers in six countries were allocated to DIALOG or treatment as usual; 507 people with schizophrenia or related disorders were included. Every 2 months for 1 year, clinicians asked patients to rate satisfaction with quality of life and treatment, and request additional or different support. Responses were fed back immediately in screen displays, compared with previous ratings and discussed. Primary outcome was subjective quality of life, and secondary outcomes were unmet needs and treatment satisfaction.
  
  
  RESULTS
  Of 507 patients, 56 were lost to follow-up and 451 were included in intention-to-treat analyses. Patients receiving the DIALOG intervention had better subjective quality of life, fewer unmet needs and higher treatment satisfaction after 12 months.
  
  
  CONCLUSIONS
  Structuring patient-clinician dialogue to focus on patients' views positively influenced quality of life, needs for care and treatment satisfaction.
authors.affiliation: Unit for Social and Community Psychiatry, Queen Mary, University of London, Newham Centre for Mental Health, London, UK. S.Priebe@qmul.ac.uk
authors.forename: Stefan
authors.initials: S
authors.lastname: Priebe
authors.forename: Rosemarie
authors.initials: R
authors.lastname: McCabe
authors.forename: Jens
authors.initials: J
authors.lastname: Bullenkamp
authors.forename: Lars
authors.initials: L
authors.lastname: Hansson
authors.forename: Christoph
authors.initials: C
authors.lastname: Lauber
authors.forename: Rafael
authors.initials: R
authors.lastname: Martinez-Leal
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.forename: Hans
authors.initials: H
authors.lastname: Salize
authors.forename: Bengt
authors.initials: B
authors.lastname: Svensson
authors.forename: Francisco
authors.initials: F
authors.lastname: Torres-Gonzales
authors.forename: Rob
authors.initials: R
authors.lastname: van den Brink
authors.forename: Durk
authors.initials: D
authors.lastname: Wiersma
authors.forename: Donna J
authors.initials: DJ
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003142:Communication; D003156:Community Mental Health Services / Q000379:methods*; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008875:Middle Aged; D020380:Needs Assessment; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011594:Psychometrics; D011788:Quality of Life; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome