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. 2015 May 14:13:115.
doi: 10.1186/s12916-015-0356-x.

Taxonomy of the burden of treatment: a multi-country web-based qualitative study of patients with chronic conditions

Viet-Thi Tran  1   2   3 , Caroline Barnes  4 , Victor M Montori  5 , Bruno Falissard  6   7 , Philippe Ravaud  8   9   10   11
Affiliations

Taxonomy of the burden of treatment: a multi-country web-based qualitative study of patients with chronic conditions

Viet-Thi Tran et al. BMC Med. .

Abstract

Background: Management strategies for patients with chronic conditions are becoming increasingly complex, which may result in a burden of treatment for patients. To develop a Minimally Disruptive Medicine designed to reduce the burden of treatment, clinicians need to understand which healthcare tasks and aggravating factors may be responsible for this burden. The objective of the present study was to describe and classify the components of the burden of treatment for patients with chronic conditions from the patient's perspective.

Methods: We performed a multi-country qualitative study using an online survey and a purposive sampling strategy to select English-, French-, and Spanish-speaking participants with different chronic conditions. Participants were recruited by physicians, patients' associations, advertisement on social media, and 'snowballing'. The answers were analyzed by i) manual content analysis with a grounded theory approach, coded by two researchers, and ii) automatic textual analysis by Reinert's method.

Results: Between 2013 and 2014, 1,053 participants from 34 different countries completed the online survey using 408,625 words. Results from both analyses were synthesized in a taxonomy of the burden of treatment, which described i) the tasks imposed on patients by their diseases and by their healthcare system (e.g., medication management, lifestyle changes, follow-up, etc.); ii) the structural (e.g., access to healthcare resources, coordination between care providers), personal, situational, and financial factors that aggravated the burden of treatment; and iii) patient-reported consequences of the burden (e.g., poor adherence to treatments, financial burden, impact on professional, family, and social life, etc.). Our findings may not be applicable to patients with chronic conditions who differ from those who responded to our survey.

Conclusions: Our taxonomy of the burden of treatment, provided by patients with chronic conditions from different countries and settings, supports the development of tools to ascertain the burden of treatment and highlights potential targets for interventions to minimize it.

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Figures

Fig. 1
Fig. 1
Flow of patients in the study. * “Number of unique visitors” from May 22, 2013 to March 30, 2014, assessed by use of Google Analytics. “Unique visitors” can include study participants, non-eligible patients, physicians, researchers, members of patient associations, or curious visitors. Details on the method of calculating the number of users can be found at https://support.google.com/analytics/answer/2992042?hl=en
Fig. 2
Fig. 2
Taxonomy of the burden of treatment
See this image and copyright information in PMC

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References

    1. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380:37–43. doi: 10.1016/S0140-6736(12)60240-2. - DOI - PubMed
    1. Bower P, Macdonald W, Harkness E, Gask L, Kendrick T, Valderas JM, et al. Multimorbidity, service organization and clinical decision making in primary care: a qualitative study. Fam Pract. 2011;28:579–87. doi: 10.1093/fampra/cmr018. - DOI - PubMed
    1. Tinetti ME, Fried T. The end of the disease era. Am J Med. 2004;116:179–85. doi: 10.1016/j.amjmed.2003.09.031. - DOI - PubMed
    1. Tinetti ME, Bogardus ST, Jr, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. N Engl J Med. 2004;351:2870–4. doi: 10.1056/NEJMsb042458. - DOI - PubMed
    1. Boyd CM, Darer J, Boult C, Fried LP, Boult L, Wu AW. Clinical practice guidelines and quality of care for older patients with multiple comorbid diseases: implications for pay for performance. JAMA. 2005;294:716–24. doi: 10.1001/jama.294.6.716. - DOI - PubMed

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