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


METHODS
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%).


CONCLUSIONS
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.
Faculty of Health Sciences, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK, lej1a12@soton.ac.uk.
L E
LE
Jones
L C
LC
Roberts
P S
PS
Little
M A
MA
Mullee
J A
JA
Cleland
C
C
Cooper
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D001416:Back Pain / Q000628:therapy*; D003657:Decision Making; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000706:statistics & numerical data*; D059825:Physical Therapists; D011320:Primary Health Care; D017064:Process Assessment, Health Care; D011369:Professional-Patient Relations; D012017:Referral and Consultation; D006113:United Kingdom; D014741:Video Recording; D055815:Young Adult