Factors associated with level of shared decision making in Malaysian primary care consultations

•First use of the OPTION tool to measure shared decision-making in an Asian setting.•Overall shared decision-making score was lower than scores published elsewhere.•Increased consultation time was significantly associated with a better SDM score.•Scores for the ethnic majority were better than for the minorities. To measure the level of shared decision-making (SDM) in primary care consultations in Malaysia, a multicultural, middle-income developing country. A cross-sectional study was conducted in an urban, public primary care clinic. Convenience sampling was used to recruit participants, and audio-recorded consultations were scored for SDM levels by two independent raters using the OPTION tool. Univariate and multivariate analysis was conducted to determine factors significantly associated with SDM levels. 199 patients and 31 doctors participated. Mean consultation time was 14.3 min (+ SD 5.75). Patients’ age ranged from 18 to 87 years (median age of 57.5 years). 52.8 % of patients were female, with three main ethnicities (Malay, Chinese, Indian). The mean OPTION score was found to be 7.8 (+ SD 3.31) out of 48. After a multivariate analysis, only patient ethnicity (β= -0.142, p