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However, older adults frequently face multiple chronic conditions (MCC). Therefore, implementing SDM requires special features. The aim of this paper is to describe the development of an intervention to improve SDM in older adults with MCC.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Following the Medical Research Council framework for developing complex interventions, the SDM<jats:sup>MCC<\/jats:sup> intervention was developed step-wise. Based on a literature review and empirical research in a co-creation process with end users, we developed training for geriatricians and a preparatory tool for older patients with MCC and informal caregivers. After assessing feasibility, the intervention was implemented in a pilot study (<jats:italic>N<\/jats:italic>\u2009=\u2009108) in two outpatient geriatric clinics of an academic and a non-academic teaching hospital in Amsterdam, the Netherlands.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Key elements of the training for geriatricians include developing skills to involve older adults with MCC and informal caregivers in SDM and following the six-step \u2018Dynamic model for SDM with frail older patients\u2019, as well as learning how to explore personal goals related to quality of life and how to form a partnership with the patient and the informal caregiver. Key elements of the preparatory tool for patients include an explicit invitation to participate in SDM, nomination that the patient\u2019s own knowledge is valuable, invitation to form a partnership with the geriatrician, encouragement to share information about daily and social functioning and exploration of possible goals. Furthermore, the invitation of informal caregivers to share their concerns was also a key element.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Through a process of co-creation, both training for geriatricians and a preparatory tool for older adults and their informal caregivers were developed, tailored to the needs of the end users and based on the \u2018Dynamic model of SDM with frail older patients\u2019.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12911-020-1022-6","type":"journal-article","created":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T13:03:25Z","timestamp":1582117405000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["The development of the evidence-based SDMMCC intervention to improve shared decision making in geriatric outpatients: the DICO study"],"prefix":"10.1186","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4618-3837","authenticated-orcid":false,"given":"Ruth E.","family":"Pel-Littel","sequence":"first","affiliation":[]},{"given":"Julia C. 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Written informed consent was obtained from all patients, informal caregivers and geriatricians.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors consent to publish this manuscript. The persons on the pictures used in the patient preparatory tool were professional models, they signed an agreement on the use of their pictures.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"35"}}