The development of a prototype measure of the co-production of health in routine consultations for people with long-term conditions.

Abstract

OBJECTIVES: (i) To develop a prototype measure of co-production of health (CPH) in consultations for people with long-term conditions (LTCs); and (ii) to undertake initial validation of it, using a measure of patient-centred care, as defined by the Roter interaction analysis system (RIAS). METHODS: Mixed methods were applied. A qualitative study gathered 11 experts' views on what comprised CPH behaviours. These were operationalised and a prototype measure applied to a convenience sample of 50 video-recorded consultations involving clinicians trained in self-management support and patients with LTCs at health services in six UK locations. RESULTS: Twenty-two CPH behaviours were identified. High frequencies of CPH behaviours in consultations were associated with greater patient-centeredness, less clinician verbal dominance, and more patient communication control in comparison to consultations where CPH behaviours were less frequent. CONCLUSION: Although the CPH tool is promising, further testing is required in order to improve reliability and validity. PRACTICAL IMPLICATIONS: In the future, the measure could be used to test interventions to promote patient participation in decision making about self-management.