1. DIALOG and DIALOG+ - News
Eoin Golden and Stefan Priebe

2. DIALOG “How satisfied are you with your…”
mental health physical health
job situation accommodation
leisure activities partner/family
friendships personal safety
medication practical help received
meetings
Rating of each domain from 1-7
“Do you need additional help?”

3. First trial
507 patients with schizophrenia/related disorder from 6 European countries
On average used 4 times over 12 months
After 12 months:
-improved quality of life
-improved treatment satisfaction
-fewer unmet needs
Small effect size, higher in East London

4. DIALOG scale
8 Quality of life items – high internal consistency correlation with full MANSA score 0.94 covering the same factorial structure
3 treatment satisfaction items good internal consistency
Each item meaningful
Efficient outcome measure

5. The EPOS project Redesign of software
Extension of intervention: DIALOG+
Randomised controlled trial to test the effectiveness of the DIALOG+ intervention

6. Previous software

7. Current software Tablet device (iPad) Touch screen Intuitive interface
Easily shared between patient and clinician

11. 4-step approach Based on solution focused therapy
Understanding: why? what is working?
Looking forward: best-case scenario? smallest improvement?
Considering options: what can the patient do? what can the clinician do? what can others do?
Agreeing on actions

13. EPOS trial: design Cluster randomised controlled trial
DIALOG+ versus active control
6-month intervention period
Outcomes assessed at baseline, 3 months, 6 months and 12 months
Primary outcome: Quality of Life - MANSA

14. Inclusion criteria: patients
Age years
Treatment in community team for at least 1M
No planned discharge for the next six months
Diagnosis ICD-10 F20-29
Capacity to give informed consent
Mean MANSA score of <5
Sufficient command of English language
179 patients at baseline

15. Implementation 30% of patients never started DIALOG+
2.6 sessions (SD=1.3) in the first 3 months
1.5 sessions (SD=1.1) in the second 3 months
4.1 sessions (SD=1.9) in total

16. Results Better quality of life after 3, 6 and 12 months
Lower levels of general symptoms after 3, 6 and 12 months
Fewer unmet needs after 3 and 6 months
Better objective social situation after 12 months
Lower overall treatment costs over 12 months

17. Other outcomes No effect on other outcomes:
Treatment satisfaction (CSQ-8)
Self-Efficacy (GSS)
Well-being ( WEMWBS)
Positive symptoms (PANSS-positive)
Negative symptoms (PANSS-negative)
Therapeutic relationship (STAR-Patient and STAR-Clinician)

18. Summary of findings
Effect sizes to match costly, intensive interventions (3m SQOL: d = 0.34)
Effect remains even after stopping
Findings do not reflect a general appraisal across scores
Cost savings

19. Implications
DIALOG+ turns routine meetings into therapeutically effective interventions – identifying needs, discussing, and initiating change
Low cost, effective intervention
Generic intervention
Easily implemented - no disruption to services
Provides meaningful routine outcome data

20. Downloading DIALOG app
iPad users only (future plans to develop for Android users – watch this space)
Visit the following link on your iPad:
Or search for ‘DIALOG’ (in caps) on the App Store and look out for this icon in the results:

21. Customising DIALOG app
Enter ‘settings’ on your iPad home screen
Enter the DIALOG settings from the list of your apps on the left
Set ‘Additional Help’ and ‘DIALOG+’ to off for basic DIALOG scale
Activate ‘Additional Help’ for extra help question
Activate ‘DIALOG+’ for full solution focused intervention

22. Customising DIALOG app
Set these buttons to ‘on’ or ‘off’ as desired

23. Contact details