Wolfson Institute of Preventive Medicine

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Effective patient-clinician interaction to improve treatment outcomes for patients with psychosis

Centre for Psychiatry

Funding Body: National Institute for Health Research
Project Investigator: Stefan Priebe


In NHS Community Mental Health Teams (CMHTs), patients and their keyworkers meet regularly but the communication within meetings is not guided by research evidence.
’DIALOG’ (a computer-mediated procedure) is the first method to structure this communication shown to be associated with more favourable long term outcomes in a RCT [1].
The interaction is structured to cover a comprehensive range of possible needs for care, focus on the patient’s view of their situation and needs, and increase the key worker’s awareness of the patient’s perspective.

Following the DIALOG study, the NIHR have funded the ’EPOS’ programme to further develop DIALOG (improving the technology and linking it with a simple psychological intervention) as well as testing the effectiveness of the improved version.

Activities & outputs

The new intervention; DIALOG+, runs on a tablet and also generates regular outcome data (i.e. patients’ ratings of satisfaction with life, treatment satisfaction and needs for further care) in such a way that is meaningful to clinicians and patients, and likely to facilitate routine outcome assessment in NHS secondary mental health services. The data can also be used to evaluate services on local, regional and national levels.
The effectiveness of DIALOG+ is being tested in a pragmatic RCT; The EPOS Trial, conducted with 36 keyworkers and 180 patients in CMHTs in the East London NHS Foundation Trust. We are investigating whether structuring the keyworker-patient communication using DIALOG+ in routine meetings will result in subjective patient improvements with regards to their quality of life, treatment satisfaction, well-being and other clinical outcomes for patients with a diagnosis of schizophrenia and related disorders. The findings should help to improve the well-being of service users and make routine outcome assessment easier in these services.

For more information visite: The EPOS Trial

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