Catherine Lamoureux-Lamarche1,2, Djamal Berbiche1,2, Helen-Maria Vasiliadis1,2. 1. Faculty of Medicine and Health Sciences, 12370Campus de Longueuil-Université de Sherbrooke, Longueuil, Quebec, Canada. 2. Centre de recherche Charles-Le Moyne, 150 Place Charles-Le Moyne, Longueuil, Quebec, Canada.
Abstract
OBJECTIVE: To assess the individual and health system factors and health-related outcomes associated with perceived need for mental health care in older adults consulting in primary care. METHOD: This longitudinal cohort study was conducted among 771 cognitively intact older adults aged ≥65 years recruited in primary care practices in Quebec between 2011 and 2013 and followed 4 years later. Predisposing, enabling and need factors were based on Andersen's framework on help-seeking behaviors. Health-related outcomes included course of common mental disorders (CMDs), change in quality of life and societal costs. Perceived need for care (PNC) was categorized as no need, met and unmet need. Multinomial regression analyses were conducted to assess the association between study variables and PNC in the overall and the subsample of participants with a CMD at baseline. RESULTS: As compared with individuals reporting no need, those with an unmet need were more likely to have cognitive decline and lower continuity of care; while those with a met need were more likely to report decreased health-related quality of life. As compared with individuals with an unmet need, those reporting a met need were more likely to report ≥ 3 physical diseases and an incident and persistent CMD, and less likely to show cognitive decline. In participants with a CMD, individuals reporting a met as compared with no need were more likely to be categorized as receiving minimally adequate care and a persistent CMD. Need for care was not associated with societal costs related to health service use. CONCLUSIONS: Overall, physicians should focus on individuals with cognitive impairment and lower continuity of care which was associated with unmet mental health need. Improved follow-up in these populations may improve health care needs and outcomes.
OBJECTIVE: To assess the individual and health system factors and health-related outcomes associated with perceived need for mental health care in older adults consulting in primary care. METHOD: This longitudinal cohort study was conducted among 771 cognitively intact older adults aged ≥65 years recruited in primary care practices in Quebec between 2011 and 2013 and followed 4 years later. Predisposing, enabling and need factors were based on Andersen's framework on help-seeking behaviors. Health-related outcomes included course of common mental disorders (CMDs), change in quality of life and societal costs. Perceived need for care (PNC) was categorized as no need, met and unmet need. Multinomial regression analyses were conducted to assess the association between study variables and PNC in the overall and the subsample of participants with a CMD at baseline. RESULTS: As compared with individuals reporting no need, those with an unmet need were more likely to have cognitive decline and lower continuity of care; while those with a met need were more likely to report decreased health-related quality of life. As compared with individuals with an unmet need, those reporting a met need were more likely to report ≥ 3 physical diseases and an incident and persistent CMD, and less likely to show cognitive decline. In participants with a CMD, individuals reporting a met as compared with no need were more likely to be categorized as receiving minimally adequate care and a persistent CMD. Need for care was not associated with societal costs related to health service use. CONCLUSIONS: Overall, physicians should focus on individuals with cognitive impairment and lower continuity of care which was associated with unmet mental health need. Improved follow-up in these populations may improve health care needs and outcomes.
Authors: W M Seekles; P Cuijpers; P van de Ven; B W J H Penninx; P F M Verhaak; A T F Beekman; A van Straten Journal: J Affect Disord Date: 2011-11-21 Impact factor: 4.839
Authors: Marijn Prins; Judith Bosmans; Peter Verhaak; Klaas van der Meer; Maurits van Tulder; Harm van Marwijk; Miranda Laurant; Mirrian Smolders; Brenda Penninx; Jozien Bensing Journal: J Eval Clin Pract Date: 2010-06-25 Impact factor: 2.431
Authors: Marijn A Prins; Peter F M Verhaak; Mirrian Smolders; Miranda G H Laurant; Klaas van der Meer; Peter Spreeuwenberg; Harm W J van Marwijk; Brenda W J H Penninx; Jozien M Bensing Journal: J Gen Intern Med Date: 2010-01-05 Impact factor: 5.128