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A prospective pre-intervention post-intervention multi-center clinical study was conducted in which an usual care group of older patients with MCC and their informal caregivers was included before the implementation of the intervention and a new cohort of patients and informal caregivers after the implementation of the intervention. SDM was observed using the OPTION\n                      <jats:sup>MCC<\/jats:sup>\n                      during video-recorded consultations. Patient- and caregivers reported outcomes regarding their role in SDM, involvement, perceived SDM and decisional conflict were measured. The differences between groups regarding the level of observed SDM (OPTION\n                      <jats:sup>MCC<\/jats:sup>\n                      ) were analyzed with a mixed model analysis. Dichotomous patient-reported outcomes were analyzed with a logistic mixed model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From two outpatient geriatric clinics 216 patients with MCCs participated. The mean age was 77.3\u00a0years, and 56.3% of patients were female. No significant difference was found in the overall level of SDM as measured with the OPTION\n                      <jats:sup>MCC<\/jats:sup>\n                      or in patient-reported outcomes. However, at item level the items discussing \u2018goals\u2019, \u2018options\u2019, and \u2018decision making\u2019 significantly improved after the intervention. The items discussing \u2018partnership\u2019 and \u2018evaluating the decision-making process\u2019 showed a significant decrease. Fifty-two percent of the patients completed the preparatory tool, but the results were only discussed in 12% of the consultations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides scope for improvement of SDM in geriatrics. Engaging older adults with MCCs and informal caregivers in the decision making process should be an essential part of SDM training for geriatricians, beyond the SDM steps of explaining options, benefits and harms. More attention should be paid to the integration of preparatory work in the consultation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12911-023-02099-2","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T07:03:19Z","timestamp":1677654199000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Effects of a shared decision making intervention for older adults with multiple chronic conditions: the DICO study"],"prefix":"10.1186","volume":"23","author":[{"given":"Ruth E.","family":"Pel-Littel","sequence":"first","affiliation":[]},{"given":"Bianca M.","family":"Buurman","sequence":"additional","affiliation":[]},{"given":"Marjolein H.","family":"van de Pol","sequence":"additional","affiliation":[]},{"given":"Jos W. 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Written informed consent was obtained from all patients, informal caregivers and geriatricians. All methods were performed in accordance with the relevant guidelines and regulations, including the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The persons on the pictures used in the patient preparatory tool were professional models, they signed an agreement on the use of their pictures. Thus, informed consent was obtained from all subjects for publication of identifying information\/images in an online open-access publication (when applicable).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"42"}}