Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
European Spine Journal
Published in: European Spine Journal 1/2014

01-04-2014 | Original Article

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

Authors: L. E. Jones, L. C. Roberts, P. S. Little, M. A. Mullee, J. A. Cleland, C. Cooper

Published in: European Spine Journal | Special Issue 1/2014

Login to get access

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.
Literature
1.
Department of Health (2004) Improving chronic disease management. Department of Health, London
2.
3.
4.
Elwyn G, Charles C (2009) Shared decision-making: the principles and the competencies. In: Edwards A, Elwyn G (eds) Evidence-based patient choice. Oxford University Press, Oxford, pp 118–143
5.
Wennberg DE, Marr A, Lang L, O’Malley S, Bennett G (2010) A randomized trial of a telephone care-management strategy. N Engl J Med 363(13):1245–1255PubMedCrossRef
6.
Elwyn G, Edwards A (2009) Shared decision-making in health care: achieving evidence-based patient choice, 2nd edn. Oxford University Press, Oxford
7.
Sandman L, Munthe C (2009) Shared decision-making and patient autonomy. Theor Med Bioeth 30(4):289–310PubMedCrossRef
8.
Loh A, Simon D, Willis CE, Kriston L, Niebling W, Hartner M (2007) The effects of a shared decision-making intervention in primary care of depression: a cluster-randomized controlled trial. Patient Educ Couns 67(3):324–332PubMedCrossRef
9.
Politi MC, Clark MA, Ombao H, Dizon D, Elwyn G (2011) Communicating uncertainty can lead to less decision satisfaction: a necessary cost of involving patients in shared decision making? Health Expect 14(1):84–91PubMedCentralPubMedCrossRef
10.
Burton D, Blundell N, Jones M, Fraser A, Elwyn G (2010) Shared decision-making in cardiology: do patients want it and do doctors provide it? Patient Educ Couns 80(2):173–179PubMedCrossRef
11.
Desroches S, Lapointe A, Deschênes SM, Gagnon MP, Légaré F (2011) Exploring dieticians’ salient beliefs about shared decision-making behaviours. Implement Sci 6(1):57PubMedCentralPubMedCrossRef
12.
Wanless D (2002) Securing our future health: taking a long-term view. HM Treasury, London, p 39
13.
King JS, Moulton BW (2006) Rethinking informed consent: the case for shared medical decision-making. Am J Law Med 32:429–501PubMed
14.
Couët N, Desroches S, Robitaille H, Vaillancourt H, Leblanc A, Turcotte S et al (2013) Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument. Health Expect. doi:10.​1111/​hex.​12054 PubMed
15.
Dierckx K, Deveugele M, Roosen P, Devisch I (2013) Implementation of shared decision making in physical therapy: observed level of involvement and patient preference. Phys Ther 93(10):1321–1330. doi:10.​2522/​ptj.​20120286 PubMedCrossRef
16.
17.
Roberts L, Bucksey S (2007) Communicating with patients: what happens in practice? Phys Ther 87(5):586–594PubMedCrossRef
18.
Elwyn G, Edwards A, Wensing M, Hood K, Atwell C, Grol R (2003) Shared decision making: developing the OPTION scale for measuring patient involvement. Qual Saf Health Care 12(2):93–99PubMedCentralPubMedCrossRef
19.
Elwyn G, Hutchings H, Edwards A, Rapport F, Wensing M, Cheung WY et al (2005) The OPTION scale: measuring the extent that clinicians involve patients in decision-making tasks. Health Expect 8(1):34–42PubMedCrossRef
20.
Elwyn G (2005) OPTION training pack: observing patient involvement. Evaluating the extent that clinicians involve patients in decisions. Department of Primary Care and Public Health, University of Cardiff
21.
Pellerin MA, Elwyn G, Rousseau M, Stacey D, Robitaille H, Le′gare′ F (2011) Toward shared decision making: using the OPTION scale to analyse resident-patient consultations in family medicine. Acad Med 86(8):1010–1018PubMedCrossRef
22.
Légaré F, Ratté S, Stacey D, Kryworuchko J, Gravel K, Graham ID, Turcotte S (2010) Interventions for improving the adoption of shared decision making by healthcare professionals. Cochrane Database Syst Rev (5):CD006732
23.
Elwyn G, Frosch D, Thompson R, Joseph-Williams N, Lloyd A, Kinnersley P et al (2012) Shared decision-making: a model for clinical practice. J Gen Intern Med 27(10):1361–1367PubMedCentralPubMedCrossRef
24.
Parsons S, Harding G, Breen A, Foster N, Pincus T, Vogel S et al (2012) Will shared decision making between patients with chronic musculoskeletal pain and physiotherapists, osteopaths and chiropractors improve patient care? Fam Pract 29(2):203–212PubMedCrossRef
Metadata
Title
Shared decision-making in back pain consultations: an illusion or reality?
Authors
L. E. Jones
L. C. Roberts
P. S. Little
M. A. Mullee
J. A. Cleland
C. Cooper
Publication date
01-04-2014
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue Special Issue 1/2014
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-014-3187-0

Other articles of this Special Issue 1/2014

European Spine Journal 1/2014 Go to the issue

Original Article

Surgical correction of scoliosis in Rett syndrome: cord monitoring and complications

Original Article

The lumbar spine has an intrinsic shape specific to each individual that remains a characteristic throughout flexion and extension

Original Article

Is NICE guidance for identifying lumbar nerve root compression misguided?

Original Article

Access-related complications in anterior lumbar surgery in patients over 60 years of age

Original Article

Complications in spinal deformity surgery in the United Kingdom: 5-year results of the annual British Scoliosis Society National Audit of Morbidity and Mortality

Reviewer's Comment

Reviewer’s comment concerning “Is NICE guidance for identifying lumbar nerve root compression misguided?” (doi:10.1007/s00586-014-3233-y by T. Germon et al.)