James E Morris1, Paul J Roderick1, Scott Harris1, Guiqing Yao2, Sam Crowe3, David Phillips4, Polly Duncan5, Simon Ds Fraser1. 1. School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton. 2. Department of Health Sciences, University of Leicester, Leicester. 3. Christchurch and Poole Council. 4. Public Health Dorset, Dorchester. 5. Centre for Academic Primary Care, University of Bristol, Bristol.
Abstract
BACKGROUND: Treatment burden is the effort required of patients to look after their health, and the impact this has on their wellbeing. Quantitative data on treatment burden for patients with multimorbidity are sparse, and no single-item treatment burden measure exists. AIM: To determine the extent of, and associations with, high treatment burden among older adults with multimorbidity, and to explore the performance of a novel single-item treatment burden measure. DESIGN AND SETTING: Cross-sectional postal survey via general practices in Dorset, UK. METHOD: Patients ≥55 years, living at home, with three or more long-term conditions (LTCs) were identified by practices. Treatment burden was measured using the Multimorbidity Treatment Burden Questionnaire. Data collected were sociodemographics, LTCs, medications, and characteristics including health literacy and financial resource. Associations with high treatment burden were investigated via logistic regression. Performance of a novel single-item measure of treatment burden was also evaluated. RESULTS: A total of 835 responses were received (response rate 42%) across eight practices. Patients' mean age was 75 years, 55% were female (n = 453), and 99% were white (n = 822). Notably, 39% of patients self-reported fewer than three LTCs (n = 325). Almost one-fifth (18%) of responders reported high treatment burden (n = 150); making lifestyle changes and arranging appointments were particular sources of difficulty. After adjustment, limited health literacy and financial difficulty displayed strong associations with high treatment burden; more LTCs and more prescribed regular medications were also independently associated. The single-item measure discriminated moderately between high and non-high burden with a sensitivity of 89%, but a specificity of 58%. CONCLUSION: High treatment burden was relatively common, underlining the importance of minimising avoidable burden. More vulnerable patients, with less capacity to manage, are at greater risk of being overburdened. Further development of a single-item treatment burden measure is required.
BACKGROUND: Treatment burden is the effort required of patients to look after their health, and the impact this has on their wellbeing. Quantitative data on treatment burden for patients with multimorbidity are sparse, and no single-item treatment burden measure exists. AIM: To determine the extent of, and associations with, high treatment burden among older adults with multimorbidity, and to explore the performance of a novel single-item treatment burden measure. DESIGN AND SETTING: Cross-sectional postal survey via general practices in Dorset, UK. METHOD:Patients ≥55 years, living at home, with three or more long-term conditions (LTCs) were identified by practices. Treatment burden was measured using the Multimorbidity Treatment Burden Questionnaire. Data collected were sociodemographics, LTCs, medications, and characteristics including health literacy and financial resource. Associations with high treatment burden were investigated via logistic regression. Performance of a novel single-item measure of treatment burden was also evaluated. RESULTS: A total of 835 responses were received (response rate 42%) across eight practices. Patients' mean age was 75 years, 55% were female (n = 453), and 99% were white (n = 822). Notably, 39% of patients self-reported fewer than three LTCs (n = 325). Almost one-fifth (18%) of responders reported high treatment burden (n = 150); making lifestyle changes and arranging appointments were particular sources of difficulty. After adjustment, limited health literacy and financial difficulty displayed strong associations with high treatment burden; more LTCs and more prescribed regular medications were also independently associated. The single-item measure discriminated moderately between high and non-high burden with a sensitivity of 89%, but a specificity of 58%. CONCLUSION: High treatment burden was relatively common, underlining the importance of minimising avoidable burden. More vulnerable patients, with less capacity to manage, are at greater risk of being overburdened. Further development of a single-item treatment burden measure is required.
Authors: David T Eton; Roger T Anderson; Jennifer L St Sauver; Elizabeth A Rogers; Mark Linzer; Minji K Lee Journal: J Multimorb Comorb Date: 2022-02-27
Authors: Hilda O Hounkpatin; Paul Roderick; James E Morris; Scott Harris; Forbes Watson; Hajira Dambha-Miller; Helen Roberts; Bronagh Walsh; Dianna Smith; Simon D S Fraser Journal: PLoS One Date: 2021-11-29 Impact factor: 3.240
Authors: Sebastian Stannard; Emilia Holland; Sarah R Crozier; Rebecca Hoyle; Michael Boniface; Mazen Ahmed; James McMahon; William Ware; Zlatko Zlatev; Nisreen A Alwan; Simon Ds Fraser Journal: BMJ Open Date: 2022-10-10 Impact factor: 3.006