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Non-uniform effectiveness of structured patient-clinician communication in community mental healthcare: an international comparison

van den Brink, Rob; Wiersma, Durk; Wolters, Kerstin; Bullenkamp, Jens; Hansson, Lars LU ; Lauber, Christoph; Martinez-Leal, Rafael; McCabe, Rosemarie; Roessler, Wulf and Salize, Hans, et al. (2011) In Social Psychiatry and Psychiatric Epidemiology 46(8). p.685-693
Abstract
The effectiveness of psychosocial interventions in community mental healthcare has been shown to depend on the setting in which they are implemented. Recently structured patient-clinician communication was found to be effective in a multi-centre trial in six European countries, the DIALOG trial. In the overall study, differences between centres were controlled for, not studied. Here, we test whether the effectiveness of structured patient-clinician communication varies between services in different countries, and explore setting characteristics associated with outcome. The study is part of the DIALOG trial, which included 507 patients with schizophrenia or related disorder, treated by 134 keyworkers. The keyworkers were allocated to... (More)
The effectiveness of psychosocial interventions in community mental healthcare has been shown to depend on the setting in which they are implemented. Recently structured patient-clinician communication was found to be effective in a multi-centre trial in six European countries, the DIALOG trial. In the overall study, differences between centres were controlled for, not studied. Here, we test whether the effectiveness of structured patient-clinician communication varies between services in different countries, and explore setting characteristics associated with outcome. The study is part of the DIALOG trial, which included 507 patients with schizophrenia or related disorder, treated by 134 keyworkers. The keyworkers were allocated to intervention or treatment as usual. Positive effects were found on quality of life (effect size 0.20: 95% CI 0.01-0.39) and treatment satisfaction (0.27: 0.06-0.47) in all centres, but reductions in unmet needs for care were only seen in two centres (-0.83 and -0.60), and in positive, negative and general symptoms in one (-0.87, -0.78, -0.87). The intervention was most effective in settings with patient populations with many unmet needs for care and high symptom levels. Psychosocial interventions in community mental healthcare may not be assumed to have uniform effectiveness across settings. Differences in patient population served and mental healthcare provided, should be studied for their influence on the effectiveness of the intervention. Structured patient-clinician communication has a uniform effect on quality of life and treatment satisfaction, but on unmet needs for care and symptom levels its effect differs between mental healthcare settings. (Less)
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Contribution to journal
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published
subject
keywords
Physician-patient relations, Computer-assisted decision making, Community mental health services, Population characteristics, Health, services research
in
Social Psychiatry and Psychiatric Epidemiology
volume
46
issue
8
pages
685 - 693
publisher
Steinkopff
external identifiers
  • wos:000292700700003
  • scopus:80051791002
ISSN
0933-7954
DOI
10.1007/s00127-010-0235-x
language
English
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yes
id
8a2c7783-ee8d-48b0-9d5a-9c62ec844cd1 (old id 2092835)
date added to LUP
2011-09-02 08:34:41
date last changed
2017-05-14 03:06:30
@article{8a2c7783-ee8d-48b0-9d5a-9c62ec844cd1,
  abstract     = {The effectiveness of psychosocial interventions in community mental healthcare has been shown to depend on the setting in which they are implemented. Recently structured patient-clinician communication was found to be effective in a multi-centre trial in six European countries, the DIALOG trial. In the overall study, differences between centres were controlled for, not studied. Here, we test whether the effectiveness of structured patient-clinician communication varies between services in different countries, and explore setting characteristics associated with outcome. The study is part of the DIALOG trial, which included 507 patients with schizophrenia or related disorder, treated by 134 keyworkers. The keyworkers were allocated to intervention or treatment as usual. Positive effects were found on quality of life (effect size 0.20: 95% CI 0.01-0.39) and treatment satisfaction (0.27: 0.06-0.47) in all centres, but reductions in unmet needs for care were only seen in two centres (-0.83 and -0.60), and in positive, negative and general symptoms in one (-0.87, -0.78, -0.87). The intervention was most effective in settings with patient populations with many unmet needs for care and high symptom levels. Psychosocial interventions in community mental healthcare may not be assumed to have uniform effectiveness across settings. Differences in patient population served and mental healthcare provided, should be studied for their influence on the effectiveness of the intervention. Structured patient-clinician communication has a uniform effect on quality of life and treatment satisfaction, but on unmet needs for care and symptom levels its effect differs between mental healthcare settings.},
  author       = {van den Brink, Rob and Wiersma, Durk and Wolters, Kerstin and Bullenkamp, Jens and Hansson, Lars and Lauber, Christoph and Martinez-Leal, Rafael and McCabe, Rosemarie and Roessler, Wulf and Salize, Hans and Svensson, Bengt and Torres-Gonzales, Francisco and Priebe, Stefan},
  issn         = {0933-7954},
  keyword      = {Physician-patient relations,Computer-assisted decision making,Community mental health services,Population characteristics,Health,services research},
  language     = {eng},
  number       = {8},
  pages        = {685--693},
  publisher    = {Steinkopff},
  series       = {Social Psychiatry and Psychiatric Epidemiology},
  title        = {Non-uniform effectiveness of structured patient-clinician communication in community mental healthcare: an international comparison},
  url          = {http://dx.doi.org/10.1007/s00127-010-0235-x},
  volume       = {46},
  year         = {2011},
}