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Chapter 3 - Needs of Older Primary Care Patients

Published online by Cambridge University Press:  10 June 2021

Juanita Hoe
Affiliation:
City, University of London
Martin Orrell
Affiliation:
University of Nottingham
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Summary

In old age, morbidity and the proportion of chronically ill patients in primary care increase. Because of multi-morbidity, older people belong to the population group with the highest use of medical services, and the general practitioner (GP) is usually the first contact point for older people.1 According to current data, the age group between 70 and 79 years shows the highest levels of utilisation of primary care services (12-month prevalence) in registered doctors’ practices with a population share of 83.4%.2 Because GPs have the highest share of medical care, they play an important role in the care of somatic and mental illness in old age. In the field of mental health in old age, dementia and depression belong to the most common disorders. Further, cardiovascular diseases and musculoskeletal disorders are among the most common physical illnesses in individuals over 75 years of age.3,4 These diseases cause not only great suffering for the affected patients but also high costs for the healthcare system.

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Publisher: Cambridge University Press
Print publication year: 2021

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References

Glaesmer, H, Gunzelmann, T, Martin, A, et al. The impact of mental disorders on health care utilization and illness behaviour in the elderly. Psychiatric Praxis 2008; 35(4):187–93.Google Scholar
Rattay, P, Butschalowsky, H, Rommel, A, et al. Utilization of outpatient and inpatient health services in Germany: Results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56(5–6):832–44.Google Scholar
Fuchs, J, Busch, M, Lange, C, Scheidt-Nave, C. Prevalence and patterns of morbidity among adults in Germany: Results of the German telephone health interview survey German Health Update (GEDA) 2009. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55(4):576–86.Google Scholar
Fuchs, J, Rabenberg, M, Scheidt-Nave, C. Prevalence of selected musculoskeletal conditions in Germany: Results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56(5–6):678–86.Google Scholar
Orrell, M, Hancock, G. CANE: Camberwell Assessment of Need for the Elderly. New York: Gaskell; 2004.Google Scholar
Walters, K, Iliffe, S, Tai, SS, Orrell, M. Assessing needs from patient, carer and professional perspectives: The Camberwell Assessment of Need for Elderly people in primary care. Age Ageing 2000; 29(6):505–10.Google Scholar
Hoogendijk, EO, Muntinga, ME, van Leeuwen, KM, et al. Self-perceived met and unmet care needs of frail older adults in primary care. Archives of Gerontology and Geriatrics 2014; 58(1):3742.Google Scholar
Stein, J, Luppa, M, König, H-H, Riedel-Heller, SG. Assessing met and unmet needs in the oldest-old and psychometric properties of the German version of the Camberwell Assessment of Need for the Elderly (CANE): A pilot study. International Psychogeriatrics 2014; 26(2):285–95.Google Scholar
Miranda-Castillo, C, Woods, B, Orrell, M. The needs of people with dementia living at home from user, caregiver and professional perspectives: A cross-sectional survey. BMC Health Services Research 2013; 13:1–10.Google Scholar
Stein, J, Pabst, A, Luck, T, et al. Unmet care needs in the oldest old primary care patients with cognitive disorders: Results of the AgeCoDe and AgeQualiDe study. Dementia and Geriatric Cognitive Disorders 2017; 44(1–2):7183.Google Scholar
Stein, J, Pabst, A, Weyerer, S, et al. The assessment of met and unmet care needs in the oldest old with and without depression using the Camberwell Assessment of Need for the Elderly (CANE): Results of the AgeMooDe study. Journal of Affective Disorders 2016; 193:309–17.CrossRefGoogle ScholarPubMed
Stein, J, Pabst, A, Weyerer, S, et al. Unmet care needs of the oldest old with late-life depression: A comparison of patient, caring relative and general practitioner perceptions—Results of the AgeMooDe study. Journal of Affective Disorders 2016; 205:182–9.Google Scholar
Stein, J, Dorow, M, Liegert, P, et al. Camberwell Assessment of Need for the Elderly (CANE): Handbuch für die adaptierte deutsche Version, 1st ed. Cologne: Psychiatrie Verlag; 2019.Google Scholar
Stein, J, Liegert, P, Dorow, M, et al. Unmet health care needs in old age and their association with depression: Results of a population-representative survey. Journal of Affective Disorders 2019; 245:9981006.CrossRefGoogle ScholarPubMed
Smith, F, Orrell, M. Does the patient-centred approach help identify the needs of older people attending primary care? Age & Ageing 2007; 36(6):628–31.Google Scholar
Asadi-Lari, M, Packham, C, Gray, D. Unmet health needs in patients with coronary heart disease: Implications and potential for improvement in caring services. Health and Quality of Life Outcomes 2003; 1:1–8.Google Scholar
Raji, YR, Abiona, T, Gureje, O. Awareness of hypertension and its impact on blood pressure control among elderly Nigerians: Report from the Ibadan study of aging. Pan African Medical Journal 2017; 27:114.Google Scholar
Mitchell, AJ, Rao, S, Vaze, A. Do primary care physicians have particular difficulty identifying late-life depression? A meta-analysis stratified by age. Psychotherapy and Psychosomatics 2010; 79(5):285–94.CrossRefGoogle ScholarPubMed
Kok, RM, Reynolds, CF. Management of depression in older adults: A review. Journal of the American Medical Association 2017; 317(20):2114–22.Google Scholar
Wittchen, H-U, Jacobi, F. Met and unmet needs for intervention: Clinical-epidemiological estimations for mental disorders in the German Health Interview and Examination Survey Supplement. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2001; 44(10):9931000.Google Scholar
Busch, MA, Neuner, B, Aichberger, MC, et al. Depressive symptomatik und inanspruchnahme von gesundheits- und pflegeleistungen bei personen im alter ab 50 Jahren in Deutschland: Ergebnisse einer bevölkerungsbasierten Querschnittstudie. Psychiatric Praxis 2013; 40(4):214–19.Google Scholar
Hancock, GA, Reynolds, T, Woods, B, et al. The needs of older people with mental health problems according to the user, the carer, and the staff. International Journal of Geriatric Psychiatry 2003; 18(9):803–11.Google Scholar
Houtjes, W, van Meijel, B, Deeg, DJH, Beekman, ATF. Major depressive disorder in late life: A multifocus perspective on care needs. Aging & Mental Health 2010; 14(7):874–80.Google Scholar
Alltag, S, Stein, J, Pabst, A, et al. Unmet needs in the depressed primary care elderly and their relation to severity of depression: Results from the AgeMooDe study. Aging & Mental Health 2017; 22(8):1032–9.Google Scholar
van der Roest, HG, Meiland, FJM, Comijs, HC, et al. What do community-dwelling people with dementia need? A survey of those who are known to care and welfare services. International Psychogeriatrics 2009; 21(5):949–65.CrossRefGoogle Scholar
Passos, J, Sequeira, C, Fernandes, L. The needs of older people with mental health problems: A particular focus on dementia patients and their carers. International Journal of Alzheimers Disease 2012; 2012:1–7.Google Scholar
Zainab, AM, Pereira, XV. Depression in primary care: Part 1. Screening and diagnosis. Malaysian Family Physician: The Official Journal of the Academy of Family Physicians of Malaysia 2007; 2(3):95101.Google Scholar
Futeran, S, Draper, BM. An examination of the needs of older patients with chronic mental illness in public mental health services. Aginging & Mental Health 2012; 16(3):327–34.Google Scholar
Sivertsen, H, Bjørkløf, GH, Engedal, K, et al. Depression and quality of life in older persons: A review. Dementia and Geriatric Cognitive Disorders 2015; 40(5–6):311–39.Google Scholar
Hybels, CF, Blazer, DG, Pieper, CF. Toward a threshold for subthreshold depression: An analysis of correlates of depression by severity of symptoms using data from an elderly community sample. Gerontologist 2001; 41(3):357–65.Google Scholar
Blazer, DG. Depression in late life: Review and commentary. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2003; 58(3):24965.Google Scholar
Fiske, A, Wetherell, JL, Gatz, M. Depression in older adults. Annual Review of Clinical Psychology 2009; 5:363–89.Google Scholar
Blazer, DG, Sachs-Ericsson, N, Hybels, CF. Perception of unmet basic needs as a predictor of depressive symptoms among community-dwelling older adults. Journal of Gerontology Series A: Biological Sciences and Medical Sciences 2007, 62(2):191–5.Google Scholar
Hancock, GA, Woods, B, Challis, D, Orrell, M. The needs of older people with dementia in residential care. International Journal of Geriatric Psychiatry 2006; 21(1):43–9.Google Scholar
van der Ploeg, ES, Bax, D, Boorsma, M, et al. A cross-sectional study to compare care needs of individuals with and without dementia in residential homes in the Netherlands. BMC Geriatrics 2013; 13:1–8.Google Scholar
Bakker, C, Vugt, ME de, van Vliet, D, Verhey, FRJ, et al. The relationship between unmet care needs in young-onset dementia and the course of neuropsychiatric symptoms: A two-year follow-up study. International Psychogeriatrics 2014; 26(12):19912000.Google Scholar
Orrell, M, Hancock, GA, Liyanage, KCG, et al. The needs of people with dementia in care homes: The perspectives of users, staff and family caregivers. International Psychogeriatrics 2008; 20(5):941–51.Google Scholar
Kaiser, G, Unger, A, Marquart, B, et al. Die Erfassung des Bedarfs bei Demenzkranken mittels Camberwell Assessment of Need (CANE) for the Elderly. Neuropsychiatrics 2010; 24(3):182–9.Google Scholar
Galeone, F, Pappalardo, S, Chieffi, S, et al. Anosognosia for memory deficit in amnestic mild cognitive impairment and Alzheimer’s disease. International Journal of Geriatric Psychiatry 2011; 26(7):695701.Google Scholar
Mak, E, Chin, R, Ng, LT, et al. Clinical associations of anosognosia in mild cognitive impairment and Alzheimer’s disease. International Journal of Geriatric Psychiatry 2015; 30(12):1207–14.Google Scholar
Levinson, W, Lesser, CS, Epstein, RM. Developing physician communication skills for patient-centered care. Health Affairs (Millwood) 2010; 29(7):1310–18.Google Scholar
Schäfer, I, Hansen, H, Schön, G, et al. The German MultiCare Study: Patterns of multimorbidity in primary health care—Protocol of a prospective cohort study. BMC Health Services Research 2009; 9:19.Google Scholar
Iliffe, S, Lenihan, P, Orrell, M, et al. The development of a short instrument to identify common unmet needs in older people in general practice. British Journal of General Practice 2004; 54(509):914–18.Google Scholar
Balsinha, C, Marques, MJ, Gonçalves-Pereira, M. A brief assessment unravels unmet needs of older people in primary care: A mixed-methods evaluation of the SPICE tool in Portugal. Primary Health Care Research & Development 2018; 19(6):637–43.Google Scholar

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