New Communication Tool Empowers Patients with Schizophrenia
PRnewsWire - January 09, 2004LONDON, January 9 /PRNewswire/
A new study published today in the leading psychiatry journal The British Journal of Psychiatry shows that a simple communication tool called 2-COM, which facilitates patient-psychiatrist communication, enables patients to play a greater role in contributing to the overall management of their condition and can lead to changes in how patients are treated. The results also found that 2-COM was of greatest value to those patients who are experiencing the most problems with the management of their disease. (1) 2-COM is a simple checklist identifying 20 common 'problems' that a person with a severe mental illness like schizophrenia might experience. The list includes problems associated with housing, relationships, money, lack of activities, psychological distress, sexuality, disease symptoms and treatment side effects. In addition, 2-COM includes a set of three scales designed to allow long term assessment of the patient's experience of treatment, ability to cope with social environments, and overall sense of well-being.
In the study, 134 patients with schizophrenia or schizoaffective disorder were randomly allocated to either standard care or standard care plus use of 2-COM. Before seeing their clinician for their routine appointment, the active group were given the 2-COM checklist to complete and asked to indicate the areas that they wanted to discuss with their clinician. Outcomes were assessed immediately after the appointment and at a follow up after six weeks. The results showed that using 2-COM induced a stable improvement in patient-reported quality of patient-psychiatrist communication irrespective of illness severity and the number of needs reported. Patients receiving 2-COM also experienced a decrease in the number of reported needs between the second and third visits. 2-COM also prompted a change in psychiatrists' clinical behavior immediately following the appointment as demonstrated by a greater likelihood of treatment change, both pharmacological and non-pharmacological. The change in treatment was also found to be more likely in those patients who reported more needs.
Professor Jim van Os, from Maastricht University, The Netherlands, and lead author of the study commented, "We are delighted that the results of this trial confirm the benefits for both patients and clinicians of adopting this simple communication tool in everyday practice. The results suggest that providing patients with an opportunity to set the agenda for their appointment may actually engender and facilitate a discussion about care needs that results in actual changes in their management that might otherwise not have occurred. These management changes may in turn ultimately result in improved patient outcomes, although further long-term analysis is needed to confirm this. On the basis of this study, we would encourage patients and psychiatrists to adopt 2-COM in their practice."
2-COM was developed by a group of leading psychiatrists from around Europe in response to research indicating improvement in patient-professional communication can lead to improved patient outcomes, and was supported by an unrestricted educational grant from AstraZeneca Neuroscience. The results of this study support earlier research published last year in the leading psychiatry journal Acta Psychiatrica Scandinavica which showed 2-COM significantly improved patients' level of satisfaction with their treatment by facilitating greater patient-psychiatrist communication in routine clinical practice. (2) The 2-COM checklist is available in nine different languages from the following web addresses: www.2coms.homestead.com or
References
1. Van Os J, Altamura AC, Bobes J, Gerlach J, Hellewell JS, Kasper S, Naber D, Robert P. (2004) Evaluation of the 2-COM communication tool as a clinical intervention: Results of a multi-national randomised controlled trial. Br J Psychiatry. Jan;184(1):79-83.
2. Van Os et al (2002) 2-COM: an instrument to facilitate patient-professional communication in routine clinical practice. Acta Psychiatr Scand
Editors notes:
European psychiatrists that contributed to the development of 2-COM included: J. van Os (Maastricht University, Netherlands); A.C. Altamura (Universita degli Studi Di Milano, Italy); J. Bobes (Universidad de Oviedo, Spain); D.C. Owens (University of Edinburgh, UK); J. Gerlach (St Hans Hospital, Denmark); J. S. E. Hellewell (Trafford General Hospital, UK); S. Kasper (University Hospital for Psychiatry, Austria); D. Naber (Klinik fur Psychiatrie und Psychotherapie der Universitat Hamburg, Germany) & P. Robert (Hopital Pasteur, France)
The European Think Tank
Copyright 2004 PRNewsWire. All Rights Reserved.