Background: Due to an ageing population, multimorbidity is becoming more common. Treatment burden (the effort required of patients to look after their health and the impact this has on their wellbeing) is prevalent in patients with multimorbidity. The Multimorbidity Treatment Burden Questionnaire (MTBQ) is a patient-reported outcome measure of treatment burden that has been validated amongst patients with multimorbidity in the UK. The aim of this study was to translate and culturally adapt the MTBQ into Chinese and to assess its reliability and validity in elderly patients with multimorbidity in hospital. Methods: The original English version of the MTBQ was translated into Chinese using Brislin's model of crossculture translation. The C-MTBQ was piloted on a sample of 30 elderly patients with multimorbidity prior to being completed by 156 Chinese elderly patients with multimorbidity recruited from a hospital in Zhengzhou, China. We examined the proportion of missing data, the distribution of responses and floor and ceiling effects for each question. Factor analysis, Cronbach's alpha, intraclass coefficient and Spearman's rank correlations assessed dimensional structure, internal consistency reliability, test-retest reliability and criterion validity, respectively. Results: The average age of the respondents was 73.5 years (range 60-99 years). The median C-MTBQ global score was 20.8 (interquartile range 12.5-29.2). Significant floor effects were seen for all items. Factor analysis supported a three-factor structure. The C-MTBQ had high internal consistency (Cronbach's alpha coefficient, 0.76) and test-retest reliability (the intraclass correlation coefficient, 0.944), the correlations between every item and global scores scored > 0.4. The scale content validity index(S-CVI) was 0.89, and the item level content validity index(I-CVI)was 0.83~1.00. The criterion validity was 0.875. Conclusion: The Chinese version of MTBQ showed satisfactory reliability and validity in elderly patients with multimorbidity, and could be used as a tool to measure treatment burden of elderly patients with multimorbidity in hospital.

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Background: There has been little research in China about treatment burden. Studies internationally have found high treatment burden is associated with number of long-term conditions, low quality of life (QoL) iand poor medication adherence. The purpose of this study is to understand factors associated with high treatment burden for older people with multimorbidity in China. Methods：A cross-sectional survey was conducted from February to May 2022. Through convenience sampling, 353 older people (≥60 years) with multimorbidity (≥2 long-term conditions) admitted to hospital in Zhengzhou, China, were invited to complete a survey including sociodemographic characteristics, long-term conditions and the Chinese version of Multimorbidity Treatment Burden Questionnaire (C-MTBQ). Ordinal logistic regression was used to identify the factors associated with high treatment burden.Results： 342 older people with multimorbidity participated (response rate 92.2%) among whom, the prevalence of no，low，medium, and high treatment burden was 1.2% (4/342)，13.9% (44/342)，49.1% (168/342)，and 36.8% (126/342), respectively. Ordinal logistic regression analysis found high treatment burden was associated with age, monthly household income，type of medical insurance，and number of long-term conditions.Conclusion：Most surveyed older people with multimorbidity experienced medium-to-high treatment burden. Interventions to reduce treatment burden for people with multimorbidity in China, should focus particularly on people at risk of higher treatment burden, namely older people with low income and high number of long-term conditions.

Background There has been little research in China about treatment burden. Studies internationally have found high treatment burden is associated with number of long-term conditions, low quality of life (QoL) iand poor medication adherence. The purpose of this study is to understand factors associated with high treatment burden for older people with multimorbidity in China. Methods A cross-sectional survey was conducted from February to May 2022. Through convenience sampling, 353 older people (≥ 60 years) with multimorbidity (≥ 2 long-term conditions) admitted to hospital in Zhengzhou, China, were invited to complete a survey including sociodemographic characteristics, long-term conditions and the Chinese version of Multimorbidity Treatment Burden Questionnaire (C-MTBQ). Ordinal logistic regression was used to identify the factors associated with high treatment burden. Results 342 older people with multimorbidity participated (response rate 92.2%) among whom, the prevalence of no, low, medium, and high treatment burden was 1.2% (4/342), 13.9% (44/342), 49.1% (168/342), and 36.8% (126/342), respectively. Ordinal logistic regression analysis found high treatment burden was associated with age, monthly household income, type of medical insurance, and number of long-term conditions. Conclusion Most surveyed older people with multimorbidity experienced medium-to-high treatment burden. Policy makers and service providers should focus particularly on people at risk of higher treatment burden, namely older people with low income, New Rural Cooperative and high number of long-term conditions. Policy should be addressed to reduce health inequalities from different types of medical insurance.