Journal of General Internal Medicine

, Volume 32, Issue 10, pp 1141–1145 | Cite as

Assessing the Burden of Treatment

  • Gabriela Spencer-Bonilla
  • Ana R. Quiñones
  • Victor M. Montori
  • On behalf of the International Minimally Disruptive Medicine Workgroup


Current healthcare systems and guidelines are not designed to adapt to care for the large and growing number of patients with complex care needs and those with multimorbidity. Minimally disruptive medicine (MDM) is an approach to providing care for complex patients that advances patients’ goals in health and life while minimizing the burden of treatment. Measures of treatment burden assess the impact of healthcare workload on patient function and well-being. At least two of these measures are now available for use with patients living with chronic conditions. Here, we describe these measures and how they can be useful for clinicians, researchers, managers, and policymakers. Their work to improve the care of high-cost, high-use, complex patients using innovative patient-centered models such as MDM should be supported by periodic large-scale assessments of treatment burden.


treatment burden multimorbidity quality measures chronic disease minimally disruptive medicine 



We would like to thank the International Minimally Disruptive Medicine workgroup, especially David T. Eton and Viet Thi Tran, for their input on earlier versions of this manuscript. The workgroup members include Summer Allen, Kasey Boehmer, Juan Pablo Brito, Ian Hargraves, Katie Gallacher, Michael R. Gionfriddo, Aaron Leppin, Frances Mair, Marc R. Matthews, Carl May, Victor M. Montori, Elizabeth Rogers, Nilay Shah, Nathan Shippee, Kate Vickery, and Kathleen Yost.

Compliance with Ethical Standards


GSB and VMM were supported by CTSA grant numbers TL1 TR000137 and UL1 TR000135, respectively, from the National Center for Advancing Translational Science (NCATS), a component of the National Institutes of Health (NIH). ARQ is supported by an American Diabetes Association career development award (ADA 7–13-CD-08). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Conflict of Interest

The authors declare that they do not have a conflict of interest.


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Copyright information

© Society of General Internal Medicine 2017

Authors and Affiliations

  • Gabriela Spencer-Bonilla
    • 1
    • 2
  • Ana R. Quiñones
    • 3
  • Victor M. Montori
    • 1
  • On behalf of the International Minimally Disruptive Medicine Workgroup
  1. 1.Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of MedicineMayo ClinicRochesterUSA
  2. 2.School of MedicineUniversity of Puerto Rico Medical Sciences CampusSan JuanUSA
  3. 3.School of Public HealthOregon Health & Science UniversityPortlandUSA

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