Extrait

Background and study aims Schizophrenia and related disorders are disabling for patients and generate high costs to the NHS and society. At present in Community Mental Health Teams (CMHTs), patients regularly meet with their key workers, but the communication between the patients and key workers is not guided by research evidence. DIALOG is a computer-mediated procedure that has been designed to structure the communication between key workers and patients in community mental health care. The aim is that this treatment approach can be used in routine care throughout the NHS, will be cost-effective and can benefit thousands of patients at the same time.We are carrying out a study of 180 patients with a diagnosis of Schizophrenia and related disorders to investigate whether structuring this communication using DIALOG will result in patient improvements in their own view of their quality of life, treatment satisfaction, well-being and other clinical outcomes. The findings should help to improve the well-being of service users and make routine outcome assessment easier in CMHTs in the NHS. Who can participate? The EPOS study aims to recruit 36 clinicians and 180 patients from Community Mental Health Teams in East London NHS Foundation Trust. What does the study involve? We are asking participating clinicians and their patients to try out one of two new approaches to treatment that includes the use of iPad computers for a period of 6 months. One approach involves patients completing a short satisfaction questionnaire called the DIALOG Scale after their routine meeting with the clinician. This scale involves rating 11 topics relevant to life and treatment (e.g. mental health, physical health, accommodation, medication). The other approach is called DIALOG+ and involves patients and clinicians using the DIALOG 2.0 software, on an iPad, together during their routine meeting. The procedure involves rating the same 11 topics as in the DIALOG Scale, and once rated the patient and clinician choose which areas they would like to address in the meeting. The chosen areas are discussed one by one, using the 4-step approach (a simple psychological approach). Following the discussion, the patient and clinician will decide together what actions can be taken to help with each of these areas. Half of the participating clinicians and their patients will be using DIALOG+, and half will be using the DIALOG Scale. At the end of the study we will compare the outcomes of both treatment groups. What are the possible benefits and risks of participating? We expect that those patients taking part will directly benefit from both treatments. The structured communication of the DIALOG+ approach is expected to be beneficial as this was the case in a previous DIALOG study. Patients completing the DIALOG Scale may benefit as evidence suggests that assessing patient satisfaction may result in improvements. There is no research to suggest that this may be harmful. All patients stand to benefit from the understanding that their treatment is being monitored and reviewed and receiving £20 per clinical interview at baseline, and months 3, 6 and 12. There are no risks associated with participating in this study. Where is the study run from? Queen Mary, University of London in collaboration with East London NHS Foundation Trust (ELFT) When is the study starting and how long is it expected to run for? Recruitment began in October 2012. We expect to stop recruiting in March 2013. Once recruited, patients and clinicians will be using the new treatments for a period of 6 months, followed by a 6-month follow-up period. The study is expected to run until 2014. Who is funding the study? National Institute for Health Research (NIHR) (UK) Who is the main contact? Lauren Kelley [email protected]

Critère d'inclusion

• Schizophrenia

Liens

• isrctn
• ictrp