title: Does meeting needs improve quality of life?
abstract: BACKGROUND
  This study investigated the relationship between patient-rated unmet needs and subjective quality of life using routine outcome data.
  
  
  METHODS
  265 mental health service patients from South Verona were assessed using the Camberwell Assessment of Need, the Lancashire Quality of Life Profile, and other standardised assessments of symptoms, disability, function and service satisfaction. At 1-year follow-up, 166 patients were still in contact, of whom 121 patients (73%) were re-assessed.
  
  
  RESULTS
  Higher baseline quality of life was associated with being male, a diagnosis of psychosis, higher disability, higher satisfaction with care, fewer staff-rated or patient-rated unmet needs, and fewer patient-rated met needs (accounting for 40% of the variance). Specifically, fewer baseline patient-rated unmet needs were cross-sectionally associated with a higher quality of life (B = -0.08, 95% CI -0.12 to -0.04). Apart from its baseline value, the only baseline predictor of follow-up QoL was patient-rated unmet need (B = -0.08, 95% CI -0.21 to -0.09), accounting for 58% of the variance in follow-up quality of life. Graphical chain modelling confirmed this association.
  
  
  CONCLUSIONS
  The association between high numbers of unmet needs and low subjective quality of life appears increasingly robust across several studies. Future research will need to investigate whether changes in needs precede changes in quality of life. This study provides further evidence that a policy of actively assessing and addressing patient-rated unmet needs may lead to improved quality of life.
authors.affiliation: Health Services Research Department, Institute of Psychiatry, London, UK. m.slade@iop.kcl.ac.uk
authors.forename: Mike
authors.initials: M
authors.lastname: Slade
authors.forename: Morven
authors.initials: M
authors.lastname: Leese
authors.forename: Mirella
authors.initials: M
authors.lastname: Ruggeri
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Kuipers
authors.forename: Michele
authors.initials: M
authors.lastname: Tansella
authors.forename: Graham
authors.initials: G
authors.lastname: Thornicroft
mesh_terms: D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology; D020380:Needs Assessment; D017060:Patient Satisfaction; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires