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

Authors: Couët, NicolasDesroches, SophieRobitaille, HubertVaillancourt, HuguesLeBlanc, AnnieTurcotte, Stéphane; Elwyn, Glyn; Légaré, France
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 associatedwith 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.
Document Type: Article de recherche
Issue Date: 22 July 2015
Open Access Date: 8 May 2017
Document version: VoR
This document was published in: Health Expectations, Vol. 18 (4), 542–561 (2015)
John Wiley & Sons Ltd
Alternative version: 10.1111/hex.12054
Collection:Articles publiés dans des revues avec comité de lecture

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