Purpose: To systematically review studies in which the OPTION instrument (Observing Patient Involvement in Decision Making) was used to assess the extent to which health professionals involve patients in decision making.
Methods: We conducted an electronic literature search of the Pubmed, PsycInfo, EBSCO, Embase, Web of Science and Google Scholar databases from 2001 to June 2011, and applied a networking strategy to find researchers likely to have used OPTION whose results were as yet unpublished. Eligible studies included: a) OPTION scores as reported outcomes and b) health professionals and patients as study participants. Extracted data included: 1) study and sample characteristics, 2) rating characteristics and psychometric results and 3) OPTION scores and their statistical associations with study variables.
Results: We analyzed 29 studies. Twenty were identified by electronic search and nine by contacting researchers. After pooling the OPTION scores drawn from observational studies and those drawn from the control/baseline groups of studies in which interventions were conducted, we computed an overall OPTION score of 22±13 (on a 0-100 scale) across the 25 studies using the revised (magnitude-based) version of the scale. Interventions to implement shared decision making (SDM) were associated with higher OPTION scores in 89% of studies assessed, while lengthening of consultations were associated with higher OPTION scores in 67% of studies assessed. At item-level, OPTION behaviors associated with “patient-centered care” tended to display lower OPTION scores than others.
Conclusions: Based on the OPTION scores collected in this review, it appears that health professionals tend to perform few behaviors to facilitate patient involvement during routine clinical encounters. In studies involving interventions to implement SDM, however, OPTION scores improved consistently. Our results support the claim that the OPTION scores are sensitive to changes in practice. Overall, our results have the potential to guide future assessments of patient involvement in decision making, as well as possible improvements to the OPTION instrument.
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