Impact of a Decision Aid on Perceptions of Shared Decision‐Making in the Primary Care Management of Patients With Subacromial Pain Syndrome: A Two‐Phased Multi‐Methods Study

Background Subacromial pain syndrome (SAPS) is the most common shoulder pain condition in primary care. Despite the importance of shared decision‐making (SDM) being increasingly recognised, its application in SAPS care remains poorly understood. The primary aim of this study was to explore the influence of a decision aid on patient and observer perceptions of SDM, and secondarily to explore correlations between these ratings in the primary care management of patients with SAPS. Methods We conducted a multi‐methods study including observations of consenting patients with SAPS in their clinical consultations with clinicians from four Danish primary care practices using OPTION‐12. We gathered patients' perceptions of SDM 2 weeks after the consultation using the CollaboRATE questionnaire and Shared Decision‐Making Questionnaire (SDM‐Q‐9). We observed consultations with and without the introduction of a decision aid tailored to support the management of patients. Results Thirty‐four consultations were observed (16 with and 18 without the decision aid). Without the aid, the mean (SD) OPTION‐12 score was 10.5 (3.3), while the median (IQR) CollaboRATE and mean (SD) SDM‐Q‐9 scores were 5 (1.3) and 22.2 (7.5), respectively. With the aid, scores significantly increased: OPTION‐12 to 22.7 (6.87, range 5–32), CollaboRATE to 6.5 (1.4), and SDM‐Q‐9 to 30.6 (8.4). Patients' and observers' OPTION‐12 and SDM‐Q‐9 scores correlated significantly across both phases, but no significant correlation was found between CollaboRATE, OPTION‐12, and SDM‐Q‐9 scores in either phase. Conclusion A decision aid significantly improved observer‐ and patient‐rated SDM in primary care consultations for patients with SAPS. Observer‐rated SDM scores more than doubled with the decision aid, and patients reported higher levels of SDM.