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Health Expect. 2015 Aug;18(4):542-61. doi: 10.1111/hex.12054. Epub 2013 Mar 4.

Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument.

Author information

1
Department of Social and Preventive Medicine, Université Laval, Québec City, QC, Canada.
2
Department of Food and Nutrition Sciences, Université Laval, Québec City, QC, Canada.
3
Institute of Nutraceuticals and Functional Foods (INAF), Québec City, QC, Canada.
4
Research Center of the Centre Hospitalier Universitaire de Québec, Hôpital St-François-D'Assise, Québec City, QC, Canada.
5
Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, USA.
6
The Dartmouth Center for Health Care Delivery Science, Hanover, NH, USA.
7
Department of Family Medicine and Emergency Medicine, Université Laval, Québec City, QC, Canada.

Abstract

BACKGROUND:

We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this.

OBJECTIVE:

To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation.

SEARCH STRATEGY:

We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking.

INCLUSION CRITERIA:

(i) OPTION scores as reported outcomes and (ii) health-care providers and patients as study participants. For analysis, we only included studies using the revised scale.

DATA EXTRACTION:

Extracted data included: (i) study and participant characteristics and (ii) OPTION outcomes (scores, statistical associations and reported psychometric results). We also assessed the quality of OPTION outcomes reporting.

MAIN RESULTS:

We found 33 eligible studies, 29 of which used the revised scale. Overall, we found low levels of patient-involving behaviours: in cases where no intervention was used to implement shared decision making (SDM), the mean OPTION score was 23 ± 14 (0-100 scale). When assessed, the variables most consistently associated with higher OPTION scores were interventions to implement SDM (n = 8/9) and duration of consultations (n = 8/15).

CONCLUSIONS:

Whatever the clinical context, few health-care providers consistently attempt to facilitate patient involvement, and even fewer adjust care to patient preferences. However, both SDM interventions and longer consultations could improve this.

KEYWORDS:

OPTION instrument; clinician-patient communication; implementation; patient involvement; shared decision making

PMID:
23451939
PMCID:
PMC5060794
DOI:
10.1111/hex.12054
[Indexed for MEDLINE]
Free PMC Article

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