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11 February 2012
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| [ Print-friendly version ] |
| An intervention to improve psychiatrist-patient communication |
| ISRCTN | ISRCTN94846422 |
| ClinicalTrials.gov identifier | |
| Public title | An intervention to improve psychiatrist-patient communication |
| Scientific title | Developing and piloting a new intervention to improve psychiatrist-patient communication about psychosis: an exploratory cluster-randomised controlled trial |
| Acronym | N/A |
| Serial number at source | PB-PG-0408-16279 |
| Study hypothesis |
We wish to address the following research questions:
1. Can psychiatrists learn to use a particular communicative mechanism (repair) to communicate more effectively with patients with psychosis? 2. Can they apply this new way of communicating with their patients? 3. Does it have an effect on the following intermediate outcomes: psychiatrist confidence in communicating with psychotic patients, patient experience of the communication and patient centredness in the first consultation with each relevant patient after the 12 week training period 4. Does it have an effect on the following patient clinical outcomes: patient satisfaction with treatment, the therapeutic relationship, treatment adherence and relapse at 6 months follow-up |
| Lay summary | |
| Ethics approval | Not provided at time of registration |
| Study design | Exploratory cluster randomised controlled trial |
| Countries of recruitment | United Kingdom |
| Disease/condition/study domain | Schizophrenia/schizoaffective disorder |
| Participants - inclusion criteria |
Psychiatrists:
Higher/advanced psychiatric trainees (ST4-6) working in outpatients or community mental health teams. Doctors in higher psychiatric training (ST4-6) already have basic knowledge and experience in psychiatry gained through core psychiatric training. During higher training they practice without direct supervision and aim to further develop specific competencies including communication skills. Hence, they are at the formative stage of their training, preparing to take up a consultant role in a few years time. We will focus on trainees in this pilot trial, because the effectiveness of an intervention on changing their communicative practice may be higher at this stage of their professional development. Patients: 1. ICD-10 criteria for a diagnosis of schizophrenia or schizoaffective disorder 2. Currently attending outpatients or being cared for by community mental health teams 3. Capable of giving informed consent 4. Aged 18 - 65 years, both females and males |
| Participants - exclusion criteria |
Patients:
1. Organic impairment 2. Require an interpreter |
| Anticipated start date | 01/03/2010 |
| Anticipated end date | 01/03/2013 |
| Status of trial | Ongoing |
| Patient information material | |
| Target number of participants | 84 (72 patients and 12 psychiatrists) |
| Interventions |
Psychiatrists will be randomised to the intervention group (training programme) or control group (no training programme).
Training programme: The proposed training programme is as follows. Training will be provided by the lead applicant, a psychiatrist and a service user in interactive groups with a maximum of 6 psychiatrists per group. Small groups are to facilitate some one-to-one work with each psychiatrist on their own recorded consultations. There will be 4 training sessions lasting 4 hours each. They will take place one week apart. During the training period, at least one consultation with a participating patient per psychiatrist will be recorded for training purposes. These consultation(s) will be viewed and psychiatrists will receive and discuss feedback in the training sessions. Four weeks after training session 4, there will be one follow-up refresher/supervision session, followed by a final refresher session eight weeks after training session 4. The proposed training schedule is: 1. Training session 1 at baseline 2. Training session 2 after one week 3. Training session 3 after two weeks 4. Training session 4 after three weeks 5. Refresher session after 8 weeks 6. Refresher session after 12 weeks At the end of the training, the next consultation between each participating psychiatrist and patient will be recorded and communicative behaviours assessed. |
| Primary outcome measure(s) | Psychiatrists use of repair will be assessed using the Repair Protocol, which is a standardised and validated measure. |
| Secondary outcome measure(s) |
Intermediate outcomes:
1. Psychiatrist confidence in communicating with psychotic patients 2. Patient experience of the communication 3. Patient centredness Measured in the first consultation with each relevant patient after the 12 week training period Final outcomes: 4. Patient satisfaction with treatment 5. Therapeutic relationship 6. Treatment adherence and relapse Measured at 6 months follow-up |
| Sources of funding | National Institute for Health Research (NIHR) (UK) - Research for Patient Benefit (RfPB) programme (ref: PB-PG-0408-16279) |
| Trial website | |
| Publications | |
| Contact name | Dr Rose McCabe |
| Address |
Unit for Social and Community Psychiatry
Newham Centre for Mental Health Glen Road |
| City/town | London |
| Zip/Postcode | E13 8SP |
| Country | United Kingdom |
| r.mccabe@qmul.ac.uk | |
| Sponsor | Queen Mary University of London (UK) |
| Address |
Queen Mary's Innovation Centre
Lower Ground Floor 5 Walden Street |
| City/town | London |
| Zip/Postcode | E1 2EF |
| Country | United Kingdom |
| Sponsor website: | http://www.qmul.ac.uk/ |
| Date applied | 30/11/2009 |
| Last edited | 15/01/2010 |
| Date ISRCTN assigned | 15/01/2010 |
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| © 2012 ISRCTN unless otherwise stated. | |
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