RT Journal Article
SR Electronic
T1 Change in treatment burden among people with multimorbidity: a follow-up survey
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP e816
OP e824
DO 10.3399/BJGP.2022.0103
VO 72
IS 724
A1 Hilda O Hounkpatin
A1 Paul Roderick
A1 Scott Harris
A1 James E Morris
A1 Dianna Smith
A1 Bronagh Walsh
A1 Helen C Roberts
A1 Hajira Dambha-Miller
A1 Qian Yue Tan
A1 Forbes Watson
A1 Simon DS Fraser
YR 2022
UL http://bjgp.org/content/72/724/e816.abstract
AB Background Treatment 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.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 revised single-item measure relative to the MTBQ.Results In 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%.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.