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Observational Study
. 2014 Apr;23 Suppl 1(Suppl 1):S13-9.
doi: 10.1007/s00586-014-3187-0. Epub 2014 Jan 30.

Shared decision-making in back pain consultations: an illusion or reality?

L E Jones  1 , L C Roberts, P S Little, M A Mullee, J A Cleland, C Cooper
Affiliations
Observational Study

Shared decision-making in back pain consultations: an illusion or reality?

L E Jones et al. Eur Spine J. 2014 Apr.

Abstract

Purpose: Amid a political agenda for patient-centred healthcare, shared decision-making is reported to substantially improve patient experience, adherence to treatment and health outcomes. However, observational studies have shown that shared decision-making is rarely implemented in practice. The purpose of this study was to measure the prevalence of shared decision-making in clinical encounters involving physiotherapists and patients with back pain.

Method: Eighty outpatient encounters (comprising 40 h of data) were observed audio-recorded, transcribed verbatim and analysed using the 12-item OPTION scale. The higher the score, the greater is the shared decision-making competency of the clinicians.

Results: The mean OPTION score was 24.0% (range 10.4-43.8%).

Conclusion: Shared decision-making was under-developed in the observed back pain consultations. Clinicians' strong desire to treat acted as a barrier to shared decision-making and further work should focus on when and how it can be implemented.

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