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

- Co-production of health (CPH) could improve healthcare communication in long-term conditions.
- A new measure of co-production of health to observe patient and clinician behaviours is presented.
- Increasing CPH will increase patient-centeredness and communication control in consultations.
- Increasing CPH will decrease clinician verbal dominance.
- CPH can be used to assess decision making about self-management in consultations.

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).MethodsMixed 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.ResultsTwenty-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.ConclusionAlthough the CPH tool is promising, further testing is required in order to improve reliability and validity.Practical implicationsIn the future, the measure could be used to test interventions to promote patient participation in decision making about self-management.