title: Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument.
abstract: BACKGROUND
  We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this.
  
  
  OBJECTIVE
  To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation.
  
  
  METHODS
  We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking.
  
  
  METHODS
  (i) OPTION scores as reported outcomes and (ii) health-care providers and patients as study participants. For analysis, we only included studies using the revised scale.
  
  
  METHODS
  Extracted data included: (i) study and participant characteristics and (ii) OPTION outcomes (scores, statistical associations and reported psychometric results). We also assessed the quality of OPTION outcomes reporting.
  
  
  RESULTS
  We found 33 eligible studies, 29 of which used the revised scale. Overall, we found low levels of patient-involving behaviours: in cases where no intervention was used to implement shared decision making (SDM), the mean OPTION score was 23 ± 14 (0-100 scale). When assessed, the variables most consistently associated with higher OPTION scores were interventions to implement SDM (n = 8/9) and duration of consultations (n = 8/15).
  
  
  CONCLUSIONS
  Whatever the clinical context, few health-care providers consistently attempt to facilitate patient involvement, and even fewer adjust care to patient preferences. However, both SDM interventions and longer consultations could improve this.
authors: Department of Social and Preventive Medicine, Université Laval, Québec City, QC, Canada.
authors: Nicolas
authors: N
authors: Couët
authors: Department of Food and Nutrition Sciences, Université Laval, Québec City, QC, Canada.|Institute of Nutraceuticals and Functional Foods (INAF), Québec City, QC, Canada.
authors: Sophie
authors: S
authors: Desroches
authors: Research Center of the Centre Hospitalier Universitaire de Québec, Hôpital St-François-D'Assise, Québec City, QC, Canada.
authors: Hubert
authors: H
authors: Robitaille
authors: Institute of Nutraceuticals and Functional Foods (INAF), Québec City, QC, Canada.
authors: Hugues
authors: H
authors: Vaillancourt
authors: Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.
authors: Annie
authors: A
authors: Leblanc
authors: Research Center of the Centre Hospitalier Universitaire de Québec, Hôpital St-François-D'Assise, Québec City, QC, Canada.
authors: Stéphane
authors: S
authors: Turcotte
authors: The Dartmouth Center for Health Care Delivery Science, Hanover, NH, USA.
authors: Glyn
authors: G
authors: Elwyn
authors: Research Center of the Centre Hospitalier Universitaire de Québec, Hôpital St-François-D'Assise, Québec City, QC, Canada.|Department of Family Medicine and Emergency Medicine, Université Laval, Québec City, QC, Canada.
authors: France
authors: F
authors: Légaré
mesh_terms: D000367:Age Factors; D003142:Communication; D003657:Decision Making; D006801:Humans; D010358:Patient Participation / Q000706:statistics & numerical data*; D057240:Patient Preference; D010817:Physician-Patient Relations; D011594:Psychometrics; D012737:Sex Factors; D013997:Time Factors
keywords: OPTION instrument; clinician-patient communication; implementation; patient involvement; shared decision making