Implementing shared decision making in Denmark: First steps and future focus areas.

What about the political climate? Although there is no explicit description of patient involvement in Danish legislation, patient-centred care is on the political agenda in Denmark. It is integrated as one of eight new national indicators of quality in health care, as well as in the most recent national plan for cancer treatment. What about tools for patient decision support? Development of evidence-based patient decision aids (PDAs) are still at an early stage in Denmark, but recent national and private funding has helped push the field forward. Furthermore, a few stakeholders have started working more systematically with developing and testing PDAs in clinical settings. What about implementation? There is growing interest among Danish health care professionals, but SDM is still far from standard practice in Denmark. Although some courses in SDM and use of PDAs now exist, few health care professionals have received systematic training, and there is little knowledge about implementation and sustainability of SDM in daily clinical practice. What does the future look like for SDM in Denmark? Future progress will depend on the extent to which SDM is systematically integrated in the daily routines of health care professionals and in patient trajectories across treatment courses. The Danish health care system needs to invest further in training and to start addressing the challenges on the organisational and system level, which affect implementation.