European Spine Journal

, Volume 23, Supplement 1, pp 13–19 | Cite as

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

  • L. E. Jones
  • L. C. RobertsEmail author
  • P. S. Little
  • M. A. Mullee
  • J. A. Cleland
  • C. Cooper
Original Article



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.


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.


The mean OPTION score was 24.0 % (range 10.4–43.8 %).


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.


Shared decision-making Patient involvement OPTION instrument Communication Patient-centred care Back pain 



The authors wish to acknowledge: the patients and staff in the former Southampton City Primary Care Trust. This work was conducted within the Southampton Musculoskeletal Research Unit. Arthritis Research UK for funding the fellowship of the lead researcher (LR).

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • L. E. Jones
    • 1
  • L. C. Roberts
    • 1
    • 2
    Email author
  • P. S. Little
    • 3
  • M. A. Mullee
    • 4
  • J. A. Cleland
    • 5
  • C. Cooper
    • 6
  1. 1.Faculty of Health SciencesUniversity of SouthamptonSouthamptonUK
  2. 2.Therapy Services DepartmentUniversity Hospitals Southampton (NHS) Foundation TrustSouthamptonUK
  3. 3.Primary Medical CareAldermoor Health CentreSouthamptonUK
  4. 4.Research Design Service South Central, Southampton General HospitalSouthamptonUK
  5. 5.Division of Medical and Dental EducationUniversity of AberdeenAberdeenUK
  6. 6.MRC Lifecourse Epidemiology UnitSouthampton General HospitalSouthamptonUK

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