Understanding Differences in Treatment Burden Among Older Adults with Multiple Chronic Conditions

TL;DR

This study explores why some older adults with multiple chronic conditions report no treatment burden despite managing many medications.

Contribution

The study identifies factors like functional wellbeing and mobility that correlate with perceived treatment burden in older adults with chronic conditions.

Findings

Participants with no treatment burden reported higher scores on PROMIS and WBS questionnaires.

Those with some burden used more assistive devices and felt tasks were more effortful.

Despite similar demographics, treatment burden perceptions varied with functional wellbeing.

Abstract

Older adults managing multiple chronic conditions (MCCs) often need to balance various medications, treatments, and interventions, so this group of older adults is expected to experience healthcare burden. In this study, we examined the treatment burden of a group of 397 veterans who were older than 65 with three or more chronic conditions and/or ten or more medications. Of this group, 115/397 surprisingly reported no burden (NB) on the Treatment Burden Questionnaire (overall score = zero) while 282/397 reported an average score of 50 during baseline data collection. A chi-square test was run on different demographic variables to determine differences between participants reporting NB versus some burden (SB). NB and SB groups had older adults of similar race, gender, ethnicity, housing status, and educational level. However, older adults reporting NB more frequently reported perfect scores on the PROMIS questionnaire (NB: 48.7%; SB: 17.4%) and a 27/30 (90%) or better on the WBS questionnaire (NB: 52.2%; SB: 19.9%). Older adults reporting SB more frequently reported using assistive devices (NB: 20%; SB: 34.8%) and feeling as if every task was effortful (NB: 23.5%; SB: 40.8). These findings suggest that despite similar background and management of MCCs, older adults with minimal functional and mobility limitations often report NB. Furthermore, perceptions of treatment burden are related to perceptions of wellbeing and quality of life.