Will Shared Decision Making Between Patients, PTs, DOs, and DCs Improve Patient Care?
Written by Editor   
Monday, March 26, 2018 07:39 AM

Chronic musculoskeletal pain (CMP) is treated in primary care by a wide range of health professionals including chiropractors, osteopaths and physiotherapists. Seeking care for any condition is not static but a process, particularly for long-term conditions such as CMP. This may need to be taken into account by both CMP patients and their treating health professionals.  Neither should assume that their views about causation and treatment are static but instead that they should be revisited on a regular basis. 

Health professionals also reflected on how patients’ developing knowledge and changing beliefs altered their expectations. Therefore, overall this study identified three themes: ‘the evolving nature of patients and health professionals models of understanding CMP’; ‘legitimating suffering’ and ‘development and tailoring of consultation and treatment strategies throughout patients’ illness careers’.

To explore patient beliefs, as well as those of DCs, DOs, and PTs, about CMP and its treatment and how these beliefs influenced care seeking and ultimately the process of care, this research conducted in-depth interviews of 13 CMP patients and 19 primary care health professionals (5 osteopaths, 4 chiropractors and 10 physiotherapists).

The patients’ models of their CMP evolved throughout the course of their condition. Health professionals’ models also evolved throughout the course of their treatment of patients. Patients developed and tailored their consultation strategies throughout their illness career but not always in a strategic fashion. 

Adopting a shared decision-making approach to treatment may be useful particularly for long-term conditions; however, in some cases, this may be easier said than done due to both patients’ and health professionals’ sometimes discomfort with adopting such an approach. Training and support for both health professionals and patients may be helpful in facilitating a shared decision-making approach.