Evaluation of the Two-Way Communication Checklist as a clinical intervention. Results of a multinational, randomised controlled trial.

Abstract

Patients and doctors often have divergent views on care needs. To examine whether providing patients with an opportunity to identify and discuss their needs would improve communication and induce changes in care. Patients with schizophrenia (n=134) were randomly allocated to either standard care or use of the Two-Way Communication Checklist (2-COM). Before seeing their clinician for a routine follow-up, participants in the active intervention group were given 2-COM, a list of 20 common needs, and told to indicate those areas they wanted to discuss with their doctor. Outcomes were assessed immediately and again after 6 weeks. Using 2-COM induced a stable improvement of patient-reported quality of patient-doctor communication (B=0.33, P=0.031), and induced changes in management immediately after the intervention (OR=3.7, P=0.009; number needed to treat, 6). Treatment change was more likely inpatients with more reported needs, and needs most likely to induce treatment change displayed stronger associations with non-medication than with medication changes. A simple intervention to aid people in discussion of their needs results in improved communication and changes in management.