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British Journal of General Practice

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Article

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

Hilda Hounkpatin, Paul Roderick, Scott Harris, James E Morris, Dianna Smith, Bronagh Walsh, Helen Roberts, Hajira Dambha-Miller, Qian Tan, Forbes Watson and Simon D Fraser
British Journal of General Practice 4 May 2022; BJGP.2022.0103. DOI: https://doi.org/10.3399/BJGP.2022.0103
Hilda Hounkpatin
1 University of Southampton, Southampton, United Kingdom
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Paul Roderick
2 University of Southampton Faculty of Medicine, Southampton, United Kingdom
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Scott Harris
3 School of Primary Care, Population Sciences & Medical Education, University of Southampton, Southampton, United Kingdom
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James E Morris
3 School of Primary Care, Population Sciences & Medical Education, University of Southampton, Southampton, United Kingdom
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Dianna Smith
1 University of Southampton, Southampton, United Kingdom
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Bronagh Walsh
2 University of Southampton Faculty of Medicine, Southampton, United Kingdom
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Helen Roberts
4 University of Southampton, Human Development and Health, Southampton, United Kingdom
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Hajira Dambha-Miller
3 School of Primary Care, Population Sciences & Medical Education, University of Southampton, Southampton, United Kingdom
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Qian Tan
1 University of Southampton, Southampton, United Kingdom
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Forbes Watson
5 NHS Dorset Clinical Commissioning Group, Poole, United Kingdom
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Simon D Fraser
3 School of Primary Care, Population Sciences & Medical Education, University of Southampton, Southampton, United Kingdom
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  • For correspondence: s.fraser@soton.ac.uk
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Abstract

Background: Treatment burden is the workload of being a patient and its impact on wellbeing. Little is known about change in treatment burden over time for people with multimorbidity. Aim: To 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 setting: A 2.5-year follow-up of a cross-sectional postal survey via six general practices in Dorset, England. Method: GP 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 single-item measure relative to the MTBQ. Results: 301 participants were recruited (77.6% response rate). Overall, there was a 2.6% increase in treatment burden. 98 (32.6%) and 53 (17.6%) participants experienced an increase and decrease, respectively, in treatment burden category. An increase in treatment burden was associated with having more than five long-term conditions (ß:8.26 (95% CI: 4.20 to 12.32) and living >10 minutes (vs.≤10 minutes) from the GP (aß:3.88 (95% CI: 1.32 to 6.43)), particularly for participants with limited health literacy (mean difference: aß:9.59 (95% CI: 2.17 to 17.00)). The single-item measure performed moderately- sensitivity: 56.5%; specificity: 92.5%. Conclusion: Treatment 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.

  • Clinical (physical)
  • Renal medicine
  • Research methods
  • Epidemiology
  • Received February 25, 2022.
  • Accepted April 29, 2022.
  • Copyright © 2022, The Authors

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Accepted Manuscript
Change in treatment burden among people with multimorbidity: a follow-up survey
Hilda Hounkpatin, Paul Roderick, Scott Harris, James E Morris, Dianna Smith, Bronagh Walsh, Helen Roberts, Hajira Dambha-Miller, Qian Tan, Forbes Watson, Simon D Fraser
British Journal of General Practice 4 May 2022; BJGP.2022.0103. DOI: 10.3399/BJGP.2022.0103

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Accepted Manuscript
Change in treatment burden among people with multimorbidity: a follow-up survey
Hilda Hounkpatin, Paul Roderick, Scott Harris, James E Morris, Dianna Smith, Bronagh Walsh, Helen Roberts, Hajira Dambha-Miller, Qian Tan, Forbes Watson, Simon D Fraser
British Journal of General Practice 4 May 2022; BJGP.2022.0103. DOI: 10.3399/BJGP.2022.0103
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Keywords

  • Clinical (physical)
  • Renal medicine
  • Research methods
  • Epidemiology

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Print ISSN: 0960-1643
Online ISSN: 1478-5242