Decreasing patient-reported burden of treatment: A systematic review of quantitative interventional studies

Abstract

Objectives To describe and analyse studies aiming at quantitatively assessing the impact of interventions on patient-reported burden of treatment as an outcome (primary or secondary). Methods The aim of the search strategy was to identify all publications describing a medical intervention intended to reduce patient-reported burden of treatment in adult patients with long-term conditions, from January 1, 2008 to July 15, 2019. Four databases (Medline, PsycINFO, the “Trials” section of the Cochrane-Library, and OpenGrey) were searched in English, French, Spanish, Italian and Portuguese. Each identified article was reviewed and the risk of bias was assessed using a tool adapted from the Cochrane Collaboration recommendations. Results Of 641 articles retrieved, 11 were included in this review. There were nine randomized controlled trials, one non-randomized controlled trial, and one before-and-after study. The sample sizes ranged from 55 to 1,546 patients. Eight out of the eleven studies reported significant positive outcomes of the studied interventions. Reducing dosing frequency, improving background therapy, offering home care or providing easier-to-use medical devices were associated with positive outcomes. Conclusions Only a few studies have specifically focused on decreasing the subjective burden of treatment. Small trials conducted in patients with a single specific disorder have reported positive outcomes. However, a large, high-quality study assessing the impact of a change in care process in patients with multiple morbidities did not show such results. Further studies are needed to implement this aspect of patient-centred care.

Adaptation and validation of a German version of the Multimorbidity Treatment Burden Questionnaire

“…Patients with multimorbidity are often seen by multiple primary and secondary healthcare professionals, each advising different treatment, including long-term medications and recommendations for diet and exercise. There is a growing body of literature recognizing the critical role of treatment burden in chronic care [ 3 ]. This concept describes the workload of health care-related tasks and its impact on patients’ daily lives and their well-being [ 4 ].…”

Longitudinal trajectories of treatment burden: A prospective survey study of adults living with multiple chronic conditions in the midwestern United States

“…Recent evidence from small-scale studies of certain individual chronic conditions like diabetes and cystic fibrosis suggests that treatment burden may be modifiable. 16 …”

Development and Validation of a Kidney-Transplant Specific Measure of Treatment Burden

“…KT recipients experiencing high treatment burden might bene t from interventions shown to lessen treatment burden in patients with other chronic conditions, including simpli ed treatment regimens and increased home-based care. 14 Furthermore, a KT-speci c measure of treatment burden could also serve as a benchmark in future clinical trials designed to improve adherence, QOL, and KT survival.…”

“…7,[10][11][12][13] Fortunately, treatment burden appears amenable to interventions like simplifying medication regimens and increasing home-based care. 14 Despite the clinical signi cance and potential reversibility of treatment burden, it is understudied in patients with chronic kidney disease (CKD), including KT recipients. Currently, there are no validated measures of treatment burden in KT recipients.…”