Assessing needs from patient, carer and professional perspectives: the Camberwell Assessment of Need for Elderly people in primary care

Background: despite evidence that needs assessment of older people can impr ove survival and function when linked to effective long-term management, th ere is no structured needs assessment tool in widespread use. The Camberwel l Assessment of Need for the Elderly is a new tool not previously evaluated in primary care. It includes the views of patients, carers and health prof essionals, enabling a direct comparison of their perspectives. Aim: to conduct a feasibility study of Camberwell Assessment of Need for th e Elderly in primary care and to compare the needs identified by patients, carers and health professionals. Methods: we selected a random sample of 1:20 of all people aged 75 and over from four general practices in inner city and suburban north-west London. We interviewed the patients, their informal carers and lead health professi onals using the Camberwell Assessment of Need for the Elderly schedule. Results: 55 (65.5%) of 84 patients, 15 (88.2%) of 17 carers and all of 55 h ealth professionals completed interviews. The patients', three most frequen tly identified unmet needs were with 'eyesight/hearing', 'psychological dis tress' and 'incontinence'. The carers' three most frequently identified unm et needs were with 'mobility', 'eyesight/hearing' and 'accommodation' and t he health professionals' were with 'daytime activities', 'accommodation' an d 'mobity '. K tests comparing patient and health professional assessments showed poor or fair agreement with 18 of the 24 variables and moderate or g ood agreement with six. None showed very good agreement. Conclusion: the Camberwell Assessment of Need for the Elderly schedule is f easible to use in primary care and can identify perceived needs not previou sly known about by health professionals. A shorter version of Camberwell As sessment of Need for the Elderly focusing on areas of poor agreement and hi gh levels of need might be useful in the assessment of needs in older peopl e in primary care.