Development of an intervention (VOLITION): To support older patients with multiple health problems in joint decision-making about their healthcare with a GP.

In the UK, the number of people aged over 65 years is increasing and over a third of spending in general practice goes towards care for older patients. Older people see a General Practitioner (GP) more often than younger patients. They are likely to have more than one long-term health problem. This is multimorbidity. It makes a patient’s healthcare needs more complex. Older patients with a greater burden of morbidity tend to have a poorer quality of life.

Patient-centred care, such as sharing in decision-making with a doctor, has positive health outcomes for patients. Outcomes include taking the doctors’ advice about treatments, feeling happier about the care received, and having more trust in the doctor. Both the World Health Organisation and the National Health Service agree that shared decision-making is important. Older patients with multimorbidity prefer sharing in decision-making about their healthcare. However, older patients are currently less often involved in such interactions when compared with younger patients, and this may have negative health effects.


  • To develop an intervention to support older patients who have more than one health problem in joint decision-making about their healthcare when visiting a GP.
  • To feasibility test the intervention, with a view to informing the design of a fully-powered clinical trial to assess its effectiveness in routine clinical care.

This project is funded by a doctoral fellowship award from the National Institute for Health Research.