Priorities in identifying unmet need in older people attending general practice: a nominal group technique study.
BACKGROUND
Primary care practitioners are encouraged to identify unmet need in older people, but the best mechanisms for doing this are not known.


OBJECTIVE
To identify common unmet needs, as perceived by older people and professionals, that could be enquired about during routine encounters in primary care.


METHODS
This was a nominal group technique qualitative study conducted with older people in London and primary care professionals working in the same localities. Subjects were seven nominal groups of 5-12 participants each, four with culturally diverse user groups recruited through local community and voluntary sector resources and three with primary care professionals (GPs and nurses). Group interviews were conducted with two facilitators and one observer recording field notes and were tape-recorded and transcribed for data collection.


RESULTS
Older people and professionals share some ideas about unmet need, but there are important differences. Older people may emphasize their autonomy and right to make choices, while professionals may use epidemiological knowledge to justify their own agendas, which may be considered intrusive. Nominal groups can be useful tools for capturing perspectives of different groups, but prioritization of themes identified by nominal groups may not always be feasible.


CONCLUSIONS
Unmet need is a complex concept, with different interpretations according to the perspective taken. Professionals relying on epidemiological knowledge to guide their enquiries about unmet needs in older patients may find that the needs that they identify are not perceived as unmet, or even meetable, by their patients.
Department of Primary Care and Population Sciences, Royal Free and University College London Medical School, University College, London, UK. v.drennan@pcps.ucl.ac.uk
Vari
V
Drennan
Kate
K
Walters
Penny
P
Lenihan
Shoshanna
S
Cohen
Sybil
S
Myerson
Steve
S
Iliffe
D000368:Aged; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D005194:Family Practice / Q000592:standards*; D005260:Female; D017144:Focus Groups; D006297:Health Services Accessibility / Q000592:standards; D006299:Health Services for the Aged / Q000592:standards* / Q000600:supply & distribution; D006801:Humans; D007407:Interviews as Topic; D008131:London; D008297:Male; D020380:Needs Assessment; D009722:Nurse Practitioners / Q000523:psychology; D017060:Patient Satisfaction; D026684:Personal Autonomy; D010821:Physicians, Family / Q000523:psychology; D036301:Qualitative Research; D012944:Social Support; D019037:Urban Health Services / Q000592:standards