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Shared decision-making in back pain consultations: an illusion or reality? |
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| Authors: | Jones L E Roberts L C Little P S Mullee M A Cleland J A Cooper C |
| Institution: | 1.Faculty of Health Sciences, University of Southampton, Highfield, Southampton, Hampshire, SO17 1BJ, UK ;2.Therapy Services Department, University Hospitals Southampton (NHS) Foundation Trust, Tremona Road, Southampton, Hampshire, SO16 6YD, UK ;3.Primary Medical Care, Aldermoor Health Centre, Aldermoor Close, Southampton, SO15 6ST, UK ;4.Research Design Service South Central, Southampton General Hospital, Tremona Road, Southampton, Hampshire, SO16 6YD, UK ;5.Division of Medical and Dental Education, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2AZ, UK ;6.MRC Lifecourse Epidemiology Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK ; |
| 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. MethodEighty 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. ResultsThe mean OPTION score was 24.0 % (range 10.4–43.8 %). ConclusionShared 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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