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

Viet Thi Tran, Caroline Barnes, Victor Manuel Montori, Bruno Falissard, Philippe Ravaud

Research output: Contribution to journalArticle

51 Citations (Scopus)

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.

Original languageEnglish (US)
Article number115
JournalBMC Medicine
Volume13
Issue number1
DOIs
StatePublished - May 14 2015

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Therapeutics
Delivery of Health Care
Social Media
Life Style
Research Personnel
Medicine
Physicians
Surveys and Questionnaires
Grounded Theory

Keywords

  • Burden of treatment
  • Chronic conditions
  • Cost of illness
  • Internet study
  • Qualitative research

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Taxonomy of the burden of treatment : A multi-country web-based qualitative study of patients with chronic conditions. / Tran, Viet Thi; Barnes, Caroline; Montori, Victor Manuel; Falissard, Bruno; Ravaud, Philippe.

In: BMC Medicine, Vol. 13, No. 1, 115, 14.05.2015.

Research output: Contribution to journalArticle

Tran, Viet Thi ; Barnes, Caroline ; Montori, Victor Manuel ; Falissard, Bruno ; Ravaud, Philippe. / Taxonomy of the burden of treatment : A multi-country web-based qualitative study of patients with chronic conditions. In: BMC Medicine. 2015 ; Vol. 13, No. 1.
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