• Br J Gen Pract · Nov 2022

    Change in treatment burden among people with multimorbidity: a follow-up survey.

    • Hilda O Hounkpatin, Paul Roderick, Scott Harris, James E Morris, Dianna Smith, Bronagh Walsh, Helen C Roberts, Hajira Dambha-Miller, Qian Yue Tan, Forbes Watson, and Simon Ds Fraser.
    • National Institute for Health and Care Research (NIHR) clinical lecturer in primary care and GP.
    • Br J Gen Pract. 2022 Nov 1; 72 (724): e816-e824.

    BackgroundTreatment burden is the effort required of patients to look after their health and the impact this has on their functioning and wellbeing. Little is known about change in treatment burden over time for people with multimorbidity.AimTo quantify change in treatment burden, determine factors associated with this change, and evaluate a revised single-item measure for high treatment burden in older adults with multimorbidity.Design And SettingA 2.5-year follow-up of a cross-sectional postal survey via six general practices in Dorset, England.MethodGP practices identified participants of the baseline survey. Data on treatment burden (measured using the Multimorbidity Treatment Burden Questionnaire; MTBQ), sociodemographics, clinical variables, health literacy, and financial resource were collected. Change in treatment burden was described, and associations assessed using regression models. Diagnostic test performance metrics evaluated the revised single-item measure relative to the MTBQ.ResultsIn total, 300 participants were recruited (77.3% response rate). Overall, there was a mean increase of 2.6 (standard deviation 11.2) points in treatment burden global score. Ninety-eight (32.7%) and 53 (17.7%) participants experienced an increase and decrease, respectively, in treatment burden category. An increase in treatment burden was associated with having >5 long-term conditions (adjusted β 8.26, 95% confidence interval [CI] = 4.20 to 12.32) and living >10 minutes (versus ≤10 minutes) from the GP (adjusted β 3.88, 95% CI = 1.32 to 6.43), particularly for participants with limited health literacy (mean difference: adjusted β 9.59, 95% CI = 2.17 to 17.00). The single-item measure performed moderately (sensitivity 55.7%; specificity 92.4%.ConclusionTreatment burden changes over time. Improving access to primary care, particularly for those living further away from services, and enhancing health literacy may mitigate increases in burden.© The Authors.

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