Treatment Burden and Chronic Illness: Who is at Most Risk?

Abstract

Background

There is a need to ascertain the type and level of treatment burden experienced by people with co-morbidities. This is important to identify the characteristics of participants who are at most risk of treatment burden.

Objective

The aim of this study is to identify the characteristics of participants who are at most risk of treatment burden.

Methods

This cross-sectional study was part of a larger project and recruitment was conducted across four Australian regions: rural, semi-rural and metropolitan. Participants were asked about their treatment burden using an adapted version of a measure, which included the following five dimensions: medication, time and administrative, lifestyle change, social life and financial burden.

Results

In total, 581 participants with various chronic health conditions reported a mean global treatment burden of 56.5 out of 150 (standard deviation = 34.5). Number of chronic conditions (β = .34, p < 0.01), age, (β = −.27, p < 0.01), the presence of an unpaid carer (β = .22, p < 0.001) and the presence of diabetes mellitus and other endocrine conditions (β = .13, p < 0.01) were significant predictors of overall treatment burden. For the five dimensions of treatment burden, social, medicine and administrative burden were predicted by the same cluster of variables: number of conditions, age, presence of an unpaid carer and diabetes. However, in addition to these variables, financial dimensions were also predicted by education level, ethnicity and health insurance. Educational level also influenced lifestyle burden.

Conclusion

A substantial proportion of community-dwelling adults with chronic conditions have considerable levels of treatment burden. Specifically, health professionals should provide greater focus on managing overall treatment burden for persons who are of young age, have an endocrine condition or an unpaid carer, or a combination of these factors.

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Notes

  1. 1.

    A government concession whereby the cost of prescription medicines for individuals and families is reduced once the PBS Safety Net threshold has been reached.

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Acknowledgments

We thank all participants for completing the survey. We are grateful to Beth Hunter, Rhonda Knights, Nicholas Moir, Brittany Williams and community leaders who supported us in recruiting participants. We thank Gabor Mihala for assistance with data management and Jean Spinks for support with data analysis.

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Correspondence to Adem Sav.

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Funding

This project was funded by the Australian Government Department of Health as part of the Fifth Community Pharmacy Agreement Research and Development Programme managed by The Pharmacy Guild of Australia. The financial assistance provided must not be taken as endorsement of the contents of this study.

Competing interests

AS, JAW, SM, EK, FK, MAK and AJW declare that they have no competing interests.

Ethical approval

Approval for this study was obtained from a University Human Ethics Committee (PHM/12/11/HREC), and from one state Government Health Department. Informed consent was obtained from all individuals who participated in the study. Thus study was conducted in accordance with the World Medical Association’s Declaration of Helsinki.

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Sav, A., Whitty, J.A., McMillan, S.S. et al. Treatment Burden and Chronic Illness: Who is at Most Risk?. Patient 9, 559–569 (2016). https://doi.org/10.1007/s40271-016-0175-y

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Keywords

  • Chronic Condition
  • Financial Burden
  • Endocrine Condition
  • Private Health Insurance
  • Stepwise Multiple Regression