An Innovative Approach to Clinical Communication in Schizophrenia: The Approaches to Schizophrenia Communication Checklists

Abstract

Side effects from antipsychotic medications can have a profound effect on patients' lives and may adversely affect their willingness to comply with treatment. Identification of side effects through improved communication between psychiatrists, other members of the healthcare team, and their patients might increase treatment compliance. The Approaches to Schizophrenia Communication (ASC) Steering Group developed two simple, practical checklists for use in the busy clinical setting. The ASC–Self-Report (ASC-SR) checklist is completed by the patient and comprises a list of the more common or clinically important side effects of antipsychotic treatment. The ASC-Clinic (ASC-C) checklist is completed by both clinician and patient together, being used as the basis for a semi-structured interview. In a multicenter pilot study set up to evaluate the utility of checklists, 86% of patients responding considered the ASC-SR to be useful in communicating their problems to psychiatrists and other members of the healthcare team. All healthcare team respondents found both checklists to be helpful when discussing side effect problems with their patients. Moreover, 41% and 47% of healthcare team respondents reported that the ASC-SR and ASC-C, respectively, had assisted them in identifying side-effect problems not previously acknowledged. Preliminary evaluation of the ASC-SR and ASC-C in this multicenter pilot study suggests that both tools were user-friendly, encouraged communication between patients and healthcare professionals about antipsychotic drug side effects, and could readily integrated into everyday clinical practice.

A review of self-report medication side effect questionnaires for mental health patients

“…This review identified six SRQs currently available that can be used in the assessment of mental health patients' subjective experiences of medication side effects (Day et al, 1995;Dott et al, 2001;Lindstrom et al, 2001;Wolters et al, 2006;Waddell and Taylor, 2008;Mojtabai et al, 2012). An evaluation of the characteristics of each study is shown in Table 1.…”

“…There was significant variation between studies in terms of design, duration, validation methods and outcomes. There were three longitudinal studies (Day et al, 1995;Wolters et al, 2006;Waddell and Taylor, 2008), one prevalence study (Lindstrom et al, 2001), a cross sectional (Mojtabai et al, 2012) and a pilot study (Dott et al, 2001). Sample sizes varied from 50 to 320 patients, and settings varied from patients' homes to clinics.…”

“…Psychiatrists have recognized this problem and there is an urgent need in clinical practice for an effective communication tool for patients to describe their subjective beliefs about the side effects of medications and their likelihood to alter or discontinue treatment (Cabeza et al, 2000;Dott et al, 2001;Dassori et al, 2003;Goff et al, 2010). Such a tool will give the clinician additional insight into the patient's experience with these medications and facilitate open dialogue with this group of patients, who as well, often have difficulty in effective communication in part due to poor or diminished cognitive ability (Dassori et al, 2003;Naber, 2008).…”

A pilot randomised controlled trial of community-led ANtipsychotic Drug REduction for Adults with Learning Disabilities

“…The proportions of people reaching threshold scores for possible mental ill health were to be compared. l The Antipsychotic Side-effect Checklist (ASC) 48 was used to measure adverse effects of psychotropic medication. The ASC comprises a list of the more common or clinically important side effects of antipsychotic treatment.…”

Antipsychotic medication side effect assessment tools: A systematic review

“…However, mental health consumers often experience difficulties in communicating openly with clinicians, possibly because they may be reluctant to fully disclose their personal circumstances, or the medication or the illness has journey for many mental health consumers (Dassori et al, 2003;De Leeuw et al, 2012;Dott et al, 2001).…”