Clinical trial NCT02435784: The Two-Way Communication Checklist (2-COM) in First Episode Psychosis Patients in Hong Kong
Official title: The Two-Way Communication Checklist (2-COM) in First Episode Psychosis Patients in Hong Kong: an Open Label Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Schizophrenia
Communication
Keywords: 2-COM
Lead sponsor: The University of Hong Kong
Sponsor class: OTHER
First posted: 2015-05-06
Enrollment: 84
Sex: ALL
Minimum age (years): 15
Maximum age (years): 64
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: The Two-Way Communication Checklist (2-COM) is a communication tool developed by van Os et al. (2002). It aims to provide an opportunity for patients to voice their needs and problem to minimize the discrepancy and miscommunication between patient and professional carer. In this randomized controlled trial, the investigators aim to examine whether using 2-COM checklist would lead to improvement in first episode psychosis patient's overall satisfaction, change in treatment option in clinicians and consultation time.

Detailed description: Communication is at the heart of psychiatric practice. Good communication has positive impact on treatment, treatment satisfaction and treatment adherence. However, different characteristics of psychosis barricade the communication between clinicians and patients. Consequently, the divergent views of needs of care between patients and clinicians may be established due to miscommunication. Such divergence may barricade the planning and the outcome of treatment.

In Hong Kong, the core psychiatric services as well as early intervention for first episode psychosis patients are provided by psychiatric outpatient clinics. Mental health services in Hong Kong are overwhelmed by large demands of the services and inadequate mental health care workforce such as low psychiatrists-to-population ratio and psychiatric nurse-to-population ratio. The large demands of services and inadequate mental health care workforce restrained the services' quality. In some busy psychiatric outpatient clinic, a clinician needs to consult 30 patients in a 3-hour session. Hui et al. (2008) study showed that the mean consultation time in one of the general psychiatric outpatient clinic in Hong Kong is 5.8 minutes.

To sum up, a cost-effectiveness instrument is in need for the early intervention psychiatric outpatient clinic in Hong Kong. The instrument has to reduce the needs' divergence, communication between clinicians and patients, and enhance the patients' involvement of clinical decision-making in the rushed psychiatric consultation. The Two-Way Communication Checklist (2-COM) may satisfy the demand.

Eligibility criteria: Inclusion Criteria:

Patients will be included if they meet the following criteria:

1. attended the EASY service;
2. were diagnosed with schizophrenia ,schizoaffective disorder or schizophreniform disorder according to ICD-10;
3. were age between 15-64;
4. were able to complete the informed consent.

Exclusion Criteria:

Patients will be excluded if they meet the following criteria:

1. had history of substance misuse;
2. had history of intellectual disability;
3. were non- Chinese speaking patients
4. had violent risk
5. had suicidal risk

Primary outcomes:
measure: Satisfaction level (patient satisfaction questionnaire)
timeFrame: within 30 minutes after a psychiatric consultation
Secondary outcomes:
measure: Change of treatment (checklist)
timeFrame: within 30 minutes after a psychiatric consultation
measure: Consultation time
timeFrame: From the time of patients' entering the consultation room till leaving the consultation room in a psychiatric consultation, up to 5 hours
Other outcomes:
Locations:
city: Hong Kong
country: Hong Kong
facility: EASY Clinic, Queen Mary Hospital
Study officials:
affiliation: Kwai Chung Hospital
name: Wing Leong Chau, RN(Psy)
role: PRINCIPAL_INVESTIGATOR
References:
citation: Lam MM, Pearson V, Ng RM, Chiu CP, Law CW, Chen EY. What does recovery from psychosis mean? Perceptions of young first-episode patients. Int J Soc Psychiatry. 2011 Nov;57(6):580-7. doi: 10.1177/0020764010374418. Epub 2010 Jul 5.
citation: Hui, C. L. M., Wong, G. H. Y., Lam, C. Y. K., Chow, P. P. L. & Chen, E. Y. H. (2008). Patients-clinician communication and needs identification for outpatients with schizophrenia in Hong Kong: role of the 2-COM instrument. Hong Kong Journal of Psychiatry, 18(2), 69-74.
citation: Chan KK, Mak WW. The mediating role of self-stigma and unmet needs on the recovery of people with schizophrenia living in the community. Qual Life Res. 2014 Nov;23(9):2559-68. doi: 10.1007/s11136-014-0695-7. Epub 2014 Apr 23.
citation: Wong GH, Hui CL, Wong DY, Tang JY, Chang WC, Chan SK, Lee EH, Xu JQ, Lin JJ, Lai DC, Tam W, Kok J, Chung DW, Hung SF, Chen EY. Developments in early intervention for psychosis in Hong Kong. East Asian Arch Psychiatry. 2012 Sep;22(3):100-4.