Table 5.

Patient-centred decision making processes

Process to achieve patient-centred decision making in primary care5	Suggested modifications for patients with LBP
Create awareness of equipoise	Create awareness of equipoise and help patient to develop a realistic illness representation. Elicit and address patients’ concerns regarding diagnosis, for example by clearly explaining why further tests are not being ordered and findings from the clinical history and assessment can confirm the diagnosis.
Discuss the potential benefits and harms of available treatments and their associated probabilities	Elicit and discuss patients’ goals for treatment in general as well as their perceptions of and preferences for available treatments, not only in terms of potential benefits and harms, but also likely mechanisms of action, practitioner credentials, and individual fit for their own particular back problem.
Elicit the patient’s views regarding the options	Provide guidance and support in negotiating the healthcare system and empower the patient to access their preferred treatment where possible within local constraints.

LBP = low back pain.