Janine Stein1, Alexander Pabst2, Siegfried Weyerer3, Jochen Werle3, Wolfgang Maier4, Lisa Miebach4, Martin Scherer5, Anne Stark5, Hanna Kaduszkiewicz6, Birgitt Wiese7, Lilia Moor7, Jens-Oliver Bock8, Hans-Helmut König8, Steffi G Riedel-Heller2. 1. Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany. Electronic address: Janine.Stein@medizin.uni-leipzig.de. 2. Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103 Leipzig, Germany. 3. Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany. 4. Department of Psychiatry, University of Bonn and German Center for Neurodegenerative Diseases Within the Helmholtz Association, Bonn, Germany. 5. Institute of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 6. Institute of General Practice, Medical Faculty, Kiel University, Kiel, Germany. 7. Institute for General Practice, Working Group Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany. 8. Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Centre Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany.
Abstract
BACKGROUND: Research showed that the perception of unmet needs may differ between patients, caregivers and professionals. Lacking agreement with regard to unmet needs between raters involved may have a negative impact on treatment of late-life depression. METHODS: As part of the multicenter German study "Late-life depression in primary care: needs, health care utilization and costs" (AgeMooDe), n=1188 primary care patients aged 75-98 with and without depression, relatives (n=366) and general practitioners (GPs, n=1152) were assessed using the German version of the Camberwell Assessment of Need for the Elderly (CANE) in order to identify patients' unmet needs from different perspectives. Kappa coefficients were computed to determine level of agreement between perspectives. Penalized likelihood logistic regression models were run in order to assess the association between depression severity and disagreement between perspectives with regard to unmet needs. RESULTS: The prevalence of unmet needs was higher in depressive patients. Kappa coefficients were on average higher for depressive patients ranging from poor to substantial. Severity of depression was significantly associated with disagreement regarding unmet needs between perspectives. LIMITATIONS: The cross-sectional design of the study limits the results. Only a part of caring relatives was able to participate. CONCLUSIONS: Perceptions of unmet needs in the oldest old primary care patients suffering from depression strongly differ between raters. Severity of depression seems to exacerbate the discrepancy between involved perspectives. The negative impact that depression severity may have on the perception and assessment of unmet needs requires greater attention by GPs.
BACKGROUND: Research showed that the perception of unmet needs may differ between patients, caregivers and professionals. Lacking agreement with regard to unmet needs between raters involved may have a negative impact on treatment of late-life depression. METHODS: As part of the multicenter German study "Late-life depression in primary care: needs, health care utilization and costs" (AgeMooDe), n=1188 primary care patients aged 75-98 with and without depression, relatives (n=366) and general practitioners (GPs, n=1152) were assessed using the German version of the Camberwell Assessment of Need for the Elderly (CANE) in order to identify patients' unmet needs from different perspectives. Kappa coefficients were computed to determine level of agreement between perspectives. Penalized likelihood logistic regression models were run in order to assess the association between depression severity and disagreement between perspectives with regard to unmet needs. RESULTS: The prevalence of unmet needs was higher in depressivepatients. Kappa coefficients were on average higher for depressivepatients ranging from poor to substantial. Severity of depression was significantly associated with disagreement regarding unmet needs between perspectives. LIMITATIONS: The cross-sectional design of the study limits the results. Only a part of caring relatives was able to participate. CONCLUSIONS: Perceptions of unmet needs in the oldest old primary care patients suffering from depression strongly differ between raters. Severity of depression seems to exacerbate the discrepancy between involved perspectives. The negative impact that depression severity may have on the perception and assessment of unmet needs requires greater attention by GPs.
Authors: Elżbieta W Buczak-Stec; André Hajek; Alexander Pabst; Christian Brettschneider; Hendrik van den Bussche; Birgitt Wiese; Siegfried Weyerer; Jochen Werle; Andreas Hoell; Michael Pentzek; Angela Fuchs; Melanie Luppa; Margit Löbner; Janine Stein; Franziska Förster; Dagmar Weeg; Edelgard Mösch; Kathrin Heser; Martin Scherer; Wolfgang Maier; Matthias C Angermeyer; Michael Wagner; Steffi G Riedel-Heller; Hans-Helmut König Journal: Front Med (Lausanne) Date: 2022-09-02