Evidence that the Two-Way Communication Checklist identifies patient-doctor needs discordance resulting in better 6-month outcome.
OBJECTIVE
To assess an intervention aimed at reducing patient-professional carer needs discordance.


METHODS
In a group of 460 patients with schizophrenia, the Two-Way Communication Checklist (2-COM), an instrument to rate needs, was completed at baseline, 2 months and 6 months by both the patient and the professional carer, allowing for the quantification of patient-carer needs discordance.


RESULTS
Reduction in patient-reported 2-COM needs in the group with low baseline needs discordance was much greater at 2 and 6 months (2 months: beta = -0.65, P < 0.001; 6 months: beta = -1.00, P < 0.001) than in the group with high baseline discordance (2 months: beta = -0.35, P < 0.001; 6 months: beta = -0.49, P < 0.001). Reduction in needs discordance between baseline and 2 months (beta = -0.07, P = 0.004) as well between 2 and 6 months (beta = -0.05, P = 0.020) was associated with greater levels of CGI clinical improvement.


CONCLUSIONS
The fact that patient-carer needs discordance impacts negatively, and its reduction positively, on 6-month outcome suggests that systematic inventory of patient-carer views on needs is necessary.
van Os
J
J
Department of Psychiatry and Neuropsychology, European Graduate School of Neuroscience, Maastricht University, Maastricht, the Netherlands. j.vanos@sp.unimaas.nl
Triffaux
J-M
JM
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001530:Belgium; D003142:Communication; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020380:Needs Assessment / Q000706:statistics & numerical data*; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D010358:Patient Participation; D010817:Physician-Patient Relations; D012559:Schizophrenia / Q000188:drug therapy / Q000628:therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
D014150:Antipsychotic Agents