Twenty-one years of the International Shared Decision Making Conference: lessons learnt and future priorities

Abstract

The first International Shared Decision Making (ISDM) Conference took place in Oxford (UK), 2001. It was attended by 120 motivated people who saw the potential of shared decision making (SDM) to lead to safer and more effective healthcare. Two years later in Swansea (UK), the conference book opened with this foreword: ‘In a few decades, the fact that we did not involve patients in the design of services and their delivery, at population and individual level, will look peculiar’ (GE and AE). Fortunately, after 21 years of the ISDM conferences, this prediction was correct. Patient involvement is not yet universal, it does not happen all the time, and there is room for improvement; but we have witnessed a paradigm shift internationally in healthcare delivery towards person-centred models. It is now more peculiar when patient involvement is not attempted or resisted, than when it is attempted or encouraged. Figure 1 summarises the ISDM conference history within this paradigm shift in healthcare, where our collective research increasingly focuses on filling gaps in scientific knowledge found in the person-centred care model, and less on changing hearts and minds about the value of the approach. However, it is important to note that the pace of change in research and clinical practice is not always the same; the reality is that important challenges to routine implementation remain. In this article, we describe what we have learnt during the 21 years of the ISDM conference, present SDM research and implementation priorities, and future challenges—what do we need to do more of so that the benefits of SDM can be realised for more people?

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