The development of a short instrument to identify common unmet needs in older people in general practice.
BACKGROUND
No structured needs assessment tool exists that is appropriate for older people and also suitable for use in routine consultations in general practice.


OBJECTIVE
To engage older people in the development of a brief, valid, practical, and acceptable instrument to help identify common unmet needs suitable for use in routine clinical practice in primary care.


METHODS
User involvement in a multi-stages approach to heuristic development.


METHODS
General practices, voluntary groups, and community organisations in north and central London.


METHODS
Subjects included patients aged 65 years and over in purposively selected practices, voluntary organisations for older people in the same localities, community organisations involving older people, general practitioners and community nurses. Data were collected through mixed methodology interviews using a structured assessment tool (Camberwell Assessment of Need for the Elderly), a postal questionnaire, and focus groups. Synthesis and interpretation of results was done through a consensus conference followed by a Delphi process involving primary care professionals.


RESULTS
Five domains of unmet need were identified as priority areas by all three data collection methods, the consensus conference, and the Delphi process: senses (vision and hearing), physical ability (mobility and falls), incontinence, cognition, and emotional distress (depression and anxiety) (SPICE).


CONCLUSIONS
Public involvement in the design of clinical tools allowed the development of a brief assessment instrument that could potentially identify common, important, and tractable unmet needs in older people.
Iliffe
Steve
S
Department of Primary Care and Population Sciences, Royal Free & University College London Medical School, London. s.iliffe@pcps.ucl.ac.uk
Lenihan
Penny
P
Orrell
Martin
M
Walters
Kate
K
Drennan
Vari
V
Tai
Sharon See
SS
D000368:Aged; D005194:Family Practice / Q000592:standards*; D006301:Health Services Needs and Demand / Q000592:standards; D006299:Health Services for the Aged / Q000600:supply & distribution*; D006801:Humans; D008131:London; D020380:Needs Assessment / Q000592:standards; D011795:Surveys and Questionnaires / Q000592:standards*; D019037:Urban Health Services / Q000592:standards