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

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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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Acknowledgments

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).

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Correspondence to L. C. Roberts.

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Jones, L.E., Roberts, L.C., Little, P.S. et al. Shared decision-making in back pain consultations: an illusion or reality?. Eur Spine J 23 (Suppl 1), 13–19 (2014). https://doi.org/10.1007/s00586-014-3187-0

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  • DOI: https://doi.org/10.1007/s00586-014-3187-0

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