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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 publication




Journal article


Eur spine j

Publication Date



23 Suppl 1


S13 - S19


Adolescent, Adult, Aged, Aged, 80 and over, Ambulatory Care, Back Pain, Decision Making, Female, General Practice, Humans, Male, Middle Aged, Patient Participation, Physical Therapists, Primary Health Care, Process Assessment (Health Care), Professional-Patient Relations, Referral and Consultation, United Kingdom, Video Recording, Young Adult