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dc.contributor.authorPriebe, S
dc.contributor.authorKelley, L
dc.contributor.authorGolden, E
dc.contributor.authorMcCrone, P
dc.contributor.authorKingdon, D
dc.contributor.authorRutterford, C
dc.contributor.authorMcCabe, Rose
dc.date.accessioned2016-02-19T14:23:08Z
dc.date.issued2013
dc.description.abstractBACKGROUND: Large numbers of patients with psychosis have regular meetings with key clinicians in the community. There is little evidence on how these meetings should be conducted to be therapeutically effective. DIALOG, a computer mediated procedure, was shown to improve outcomes in a European multi-centre trial. DIALOG structures the patient-clinician communication and makes it patient-centred, but does not guide clinicians as to how to respond to patients' concerns. DIALOG has been further developed into DIALOG+, which uses advanced software and, additionally, provides a four step approach--based on a solution focused model--for addressing patients' concerns. We designed a cluster randomised controlled trial to test the effectiveness of DIALOG+ in improving treatment outcomes of patients with psychosis in the community. METHODS/DESIGN: Key workers are recruited from community mental health teams in East London and randomly allocated to either the intervention or control group. Out of their case loads, we identify patients with schizophrenia (F 20-29) and a moderate or lower level of subjective quality of life (MANSA score <5), who are treated according to the allocation of their key workers. Key workers in the intervention group are trained in using DIALOG+ and use it with each patient over a six-month period. Control patients rate their satisfaction with life and treatment on a tablet to control for the effect of regular ratings and the use of modern technology. We are recruiting up to 42 key workers to reach a total sample size of 180 patients. Clinical and social outcomes including costs are assessed after 3, 6 and 12 months. Primary outcome is subjective quality-of-life at 6 months. DISCUSSION: The trial aims to evaluate the effectiveness of a novel intervention (DIALOG+) which uses modern technology to support routine patient-clinician meetings in community care, makes the communication patient centred and guides patients and clinicians to address concerns. DIALOG+ is a generic and widely applicable intervention. If shown as effective, it can be used to improve outcomes of community care on a large scale, ensuring that routine encounters are therapeutically effective. DIALOG+ can also be implemented across services at relatively low additional costs. TRIAL REGISTRATION: Current Controlled Trials ISRCTN34757603.en_GB
dc.description.sponsorshipNational Institute for Health Research (NIHR)en_GB
dc.identifier.citationVol. 13: 173en_GB
dc.identifier.doi10.1186/1471-244X-13-173
dc.identifier.grantnumberRP-PG-0108-10023en_GB
dc.identifier.urihttp://hdl.handle.net/10871/19975
dc.language.isoenen_GB
dc.publisherBioMed Centralen_GB
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/23802602en_GB
dc.rights© 2013 Priebe et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.en_GB
dc.subjectAdolescenten_GB
dc.subjectAdulten_GB
dc.subjectAgeden_GB
dc.subjectCommunicationen_GB
dc.subjectCommunity Mental Health Servicesen_GB
dc.subjectFemaleen_GB
dc.subjectHumansen_GB
dc.subjectMaleen_GB
dc.subjectMiddle Ageden_GB
dc.subjectPatient Satisfactionen_GB
dc.subjectPhysician-Patient Relationsen_GB
dc.subjectPsychotic Disordersen_GB
dc.subjectSchizophreniaen_GB
dc.subjectTreatment Outcomeen_GB
dc.titleEffectiveness of structured patient-clinician communication with a solution focused approach (DIALOG+) in community treatment of patients with psychosis--a cluster randomised controlled trial.en_GB
dc.typeArticleen_GB
dc.date.available2016-02-19T14:23:08Z
dc.identifier.issn1471-244X
exeter.place-of-publicationEngland
dc.identifier.journalBMC Psychiatryen_GB
dc.identifier.pmcidPMC3702422
dc.identifier.pmid23802602


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