Structured patient-clinician communication and 1-year outcome in community mental healthcare: cluster randomised controlled trial.
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.
Priebe
Stefan
S
Unit for Social and Community Psychiatry, Queen Mary, University of London, Newham Centre for Mental Health, London, UK. S.Priebe@qmul.ac.uk
McCabe
Rosemarie
R
Bullenkamp
Jens
J
Hansson
Lars
L
Lauber
Christoph
C
Martinez-Leal
Rafael
R
Rössler
Wulf
W
Salize
Hans
H
Svensson
Bengt
B
Torres-Gonzales
Francisco
F
van den Brink
Rob
R
Wiersma
Durk
D
Wright
Donna J
DJ
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