Evaluating shared decision‐making between companion animal veterinarians and their clients using the Observer OPTION⁵ instrument

Abstract

Background: Communication practices used by veterinarians can impact client's involvement in decision-making. The objective of this study was to evaluate the level of client involvement in veterinary care decisions and factors impacting client involvement. Methods: A random sample of practising companion animal veterinarians and a convenience sample of pet owners were recruited. Each consultation was audio-video recorded and analyzed using the Observer OPTION 5 instrument, adapted from human medicine, to assess veterinarians' level of shared decision-making. A mixed linear model was used to assess statistical associations between veterinarian, client and appointment-level factors and OPTION 5 scores. Results: Sixty veterinarians and 909 of their clients were audio-video recorded during a consultation, of which 717 interactions included a decision identified for analysis using the OPTION 5 instrument. Elements consistent with shared decision-making were uncommon, with a mean OPTION 5 score of 22.6 (median = 20.0; sd = 13.05; range = 0-75) out of 100. OPTION 5 scores were positively associated with the length of the appointment and negatively associated with the veterinarian's years in practice when controlling for statistical interaction between client income and appointment type. Conclusion: Findings suggest an opportunity exists for veterinarians to incorporate more client involvement through increased use of shared decisionmaking behaviours during veterinary consultations.

Implementing shared decision making in veterinary medicine

“…However, the scores were consistent with findings reported for other healthcare providers without SDM-specific training. 19 Some of the findings in Janke and colleagues' study may follow educational trends, generational differences or practice cultures. Specifically, veterinarians who had been in practice longer had fewer behaviours consistent with client involvement, which could reflect any number of factors.…”

“…Consistent with other recent research, 15,20 socioeconomic factors, appointment length and visit type also had an impact on SDM scores in Janke and colleagues' study. 19 Perhaps unsurprisingly, behaviour consultations resulted in the highest SDM scores, while vaccination appointments had the lowest scores. Further study may be warranted to determine if there is a recognition that vaccine appointments contain preference-sensitive decision-making opportunities or if those are not preferencesensitive decisions when evaluated by practitioners.…”

“…To this end, Janke and colleagues conducted a robust study, summarised on p 323 of this issue of Vet Record, evaluating the use of SDM in companion animal practice in Canada using video and audio recordings. 19 The study highlighted a disconnect between the information the veterinarian provides and what is needed by or is important to the client. 19 This disconnect was observed in both the content (ie, what is discussed) and process (ie, how it is discussed) of veterinarian-client interactions.…”

“…19 The study highlighted a disconnect between the information the veterinarian provides and what is needed by or is important to the client. 19 This disconnect was observed in both the content (ie, what is discussed) and process (ie, how it is discussed) of veterinarian-client interactions.…”

“…In contrast, items focused on the justification for deliberation (ie, acknowledging there was a preference-sensitive decision to be made) and integrating preferences were the lowest. 19 Both these items might be considered higherorder skills requiring considerable practice and confidence and may not be role modelled often or effectively in practice. Consistent with other recent research, 15,20 socioeconomic factors, appointment length and visit type also had an impact on SDM scores in Janke and colleagues' study.…”