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

Background: Patients and doctors often have divergent views on care needs. Aims: To examine whether providing patients with an opportunity to identify and discuss their needs would improve communication and induce changes in care. Method: 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. Results: 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 in patients with more reported needs, and needs most likely to induce treatment change displayed stronger associations with non-medication than with medication changes. Conclusions: A simple intervention to aid people in discussion of their needs results in improved communication and changes in management.