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European Experience with Shared Decision Making

Angela Coulter, Martin Härter Härter, Nora Moumjid-Ferdjaoui, Lilisbeth Perestelo-Perez, Trudy van der Weijden



Background: Shared decision making (SDM) is frequently advocated but not yet widely implemented in European countries. Experience suggests that various incentives must be in alignment to encourage wider uptake.


Objectives: To assess readiness for mainstream implementation of SDM in five European countries.


Methods: Qualitative assessment of clinical policies and the availability of various SDM support services in Germany, France, Spain, the Netherlands and the UK.


Results: All five countries have research groups working on SDM, patient groups calling for its wider use, and ethical and professional standards indicating its desirability, but apart from a small number of demonstration projects, there is no evidence of a systematic approach to implementation in any of the countries as yet.


Conclusions: Greater attention will need to be given to the provision of effective leadership, training and practical support if SDM is to become a regular feature of clinical practice in these countries.



shared decision making; France; Germany; Spain; Netherlands; United Kingdom

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