Factors that lessen the burden of treatment in complex patients with chronic conditions: A qualitative study

Jennifer L. Ridgeway, Jason S. Egginton, Kristina Tiedje, Mark Linzer, Deborah Boehm, Sara Poplau, Djenane Ramalho de Oliveira, Laura Odell, Victor Manuel Montori, David T Eton

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Purpose: Patients with multiple chronic conditions (multimorbidity) often require ongoing treatment and complex self-care. This workload and its impact on patient functioning and well-being are, together, known as treatment burden. This study reports on factors that patients with multimorbidity draw on to lessen perceptions of treatment burden. Patients and methods: Interviews (n=50) and focus groups (n=4 groups, five to eight participants per group) were conducted with patients receiving care in a large academic medical center or an urban safety-net hospital. Interview data were analyzed using qualitative framework analysis methods, and themes and subthemes were used to identify factors that mitigate burden. Focus groups were held to confirm these findings and clarify any new issues. This study was part of a larger program to develop a patient-reported measure of treatment burden. Results: Five major themes emerged from the interview data. These included: 1) problem-focused strategies, like routinizing self-care, enlisting support of others, planning for the future, and using technology; 2) emotion-focused coping strategies, like maintaining a positive attitude, focusing on other life priorities, and spirituality/faith; 3) questioning the notion of treatment burden as a function of adapting to self-care and comparing oneself to others; 4) social support (informational, tangible, and emotional assistance); and 5) positive aspects of health care, like coordination of care and beneficial relationships with providers. Additional subthemes arising from focus groups included preserving autonomy/independence and being proactive with providers. Conclusion: Patients attempt to lessen the experience of treatment burden using a variety of personal, social, and health care resources. Assessing these factors in tandem with patient perceptions of treatment burden can provide a more complete picture of how patients fit complex self-care into their daily lives.

Original languageEnglish (US)
Pages (from-to)339-351
Number of pages13
JournalPatient Preference and Adherence
Volume8
DOIs
StatePublished - Mar 19 2014

Fingerprint

Self Care
Focus Groups
Group
Interviews
Therapeutics
interview
health care
Comorbidity
Safety-net Providers
Delivery of Health Care
spirituality
workload
Spirituality
faith
social support
Health Resources
coping
emotion
assistance
Workload

Keywords

  • Adherence
  • Minimally disruptive medicine
  • Patient preferences
  • Patient-centered

ASJC Scopus subject areas

  • Social Sciences (miscellaneous)
  • Medicine (miscellaneous)
  • Health Policy
  • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)

Cite this

Factors that lessen the burden of treatment in complex patients with chronic conditions : A qualitative study. / Ridgeway, Jennifer L.; Egginton, Jason S.; Tiedje, Kristina; Linzer, Mark; Boehm, Deborah; Poplau, Sara; de Oliveira, Djenane Ramalho; Odell, Laura; Montori, Victor Manuel; Eton, David T.

In: Patient Preference and Adherence, Vol. 8, 19.03.2014, p. 339-351.

Research output: Contribution to journalArticle

Ridgeway, Jennifer L. ; Egginton, Jason S. ; Tiedje, Kristina ; Linzer, Mark ; Boehm, Deborah ; Poplau, Sara ; de Oliveira, Djenane Ramalho ; Odell, Laura ; Montori, Victor Manuel ; Eton, David T. / Factors that lessen the burden of treatment in complex patients with chronic conditions : A qualitative study. In: Patient Preference and Adherence. 2014 ; Vol. 8. pp. 339-351.
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