The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review

<p>Abstract</p> <p>Background</p> <p>Nonadherence to mental health treatment incurs clinical and economic burdens. The clinician-patient alliance, negotiated through clinical interaction, presents a critical intervention point. Recent medical reviews of communication an...

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Main Authors: Thompson Laura, McCabe Rose
Format: Article
Language:English
Published: BMC 2012-07-01
Series:BMC Psychiatry
Subjects:
Online Access:http://www.biomedcentral.com/1471-244X/12/87
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author Thompson Laura
McCabe Rose
author_facet Thompson Laura
McCabe Rose
author_sort Thompson Laura
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Nonadherence to mental health treatment incurs clinical and economic burdens. The clinician-patient alliance, negotiated through clinical interaction, presents a critical intervention point. Recent medical reviews of communication and adherence behaviour exclude studies with psychiatric samples. The following examines the impact of clinician-patient alliance and communication on adherence in mental health, identifying the specific mechanisms that mobilise patient engagement.</p> <p>Methods</p> <p>In December 2010, a systematic search was conducted in Pubmed, PsychInfo, Web of Science, Cochrane Library, Embase and Cinahl and yielded 6672 titles. A secondary hand search was performed in relevant journals, grey literature and reference.</p> <p>Results</p> <p>23 studies met the inclusion criteria for the review. The methodological quality overall was moderate. 17 studies reported positive associations with adherence, only four of which employed intervention designs. 10 studies examined the association between clinician-patient alliance and adherence. Subjective ratings of clinical communication styles and messages were assessed in 12 studies. 1 study examined the association between objectively rated communication and adherence. Meta-analysis was not possible due to heterogeneity of methods. Findings were presented as a narrative synthesis.</p> <p>Conclusions</p> <p>Clinician-patient alliance and communication are associated with more favourable patient adherence. Further research of observer rated communication would better facilitate the application of findings in clinical practice. Establishing agreement on the tasks of treatment, utilising collaborative styles of communication and discussion of treatment specifics may be important for clinicians in promoting cooperation with regimens. These findings align with those in health communication. However, the benefits of shared decision making for adherence in mental health are less conclusive than in general medicine.</p>
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spelling doaj.art-0cbd425aa4f44d238a57715be3fbc8c12022-12-22T00:10:42ZengBMCBMC Psychiatry1471-244X2012-07-011218710.1186/1471-244X-12-87The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic reviewThompson LauraMcCabe Rose<p>Abstract</p> <p>Background</p> <p>Nonadherence to mental health treatment incurs clinical and economic burdens. The clinician-patient alliance, negotiated through clinical interaction, presents a critical intervention point. Recent medical reviews of communication and adherence behaviour exclude studies with psychiatric samples. The following examines the impact of clinician-patient alliance and communication on adherence in mental health, identifying the specific mechanisms that mobilise patient engagement.</p> <p>Methods</p> <p>In December 2010, a systematic search was conducted in Pubmed, PsychInfo, Web of Science, Cochrane Library, Embase and Cinahl and yielded 6672 titles. A secondary hand search was performed in relevant journals, grey literature and reference.</p> <p>Results</p> <p>23 studies met the inclusion criteria for the review. The methodological quality overall was moderate. 17 studies reported positive associations with adherence, only four of which employed intervention designs. 10 studies examined the association between clinician-patient alliance and adherence. Subjective ratings of clinical communication styles and messages were assessed in 12 studies. 1 study examined the association between objectively rated communication and adherence. Meta-analysis was not possible due to heterogeneity of methods. Findings were presented as a narrative synthesis.</p> <p>Conclusions</p> <p>Clinician-patient alliance and communication are associated with more favourable patient adherence. Further research of observer rated communication would better facilitate the application of findings in clinical practice. Establishing agreement on the tasks of treatment, utilising collaborative styles of communication and discussion of treatment specifics may be important for clinicians in promoting cooperation with regimens. These findings align with those in health communication. However, the benefits of shared decision making for adherence in mental health are less conclusive than in general medicine.</p>http://www.biomedcentral.com/1471-244X/12/87CommunicationAllianceAdherenceMental health
spellingShingle Thompson Laura
McCabe Rose
The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review
BMC Psychiatry
Communication
Alliance
Adherence
Mental health
title The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review
title_full The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review
title_fullStr The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review
title_full_unstemmed The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review
title_short The effect of clinician-patient alliance and communication on treatment adherence in mental health care: a systematic review
title_sort effect of clinician patient alliance and communication on treatment adherence in mental health care a systematic review
topic Communication
Alliance
Adherence
Mental health
url http://www.biomedcentral.com/1471-244X/12/87
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