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

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

35 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)13-19
Number of pages7
JournalEuropean Spine Journal
Issue numberSuppl 1
Early online date30 Jan 2014
Publication statusPublished - Apr 2014


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


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