Eight in Ten Multimorbid Patients Experience High Treatment Burden: A Cross-sectional Survey in an Outpatient Setting

Background: Multimorbidity is linked with poor patient outcomes, polypharmacy, and treatment burden. Treatment burden is the workload needed by patients to manage their multiple chronic conditions. We aimed to assess treatment burden and its predictors in patients with multimorbidity at the internal medicine clinic of the Omdurman Teaching Hospital.
Methods: This was a descriptive, cross-sectional study. Patients were eligible for inclusion if they were aged ≥55 years and had ≥2 self-reported chronic conditions. Treatment burden was measured through the Multimorbidity Treatment Burden Questionnaire (MTBQ). Multivariable logistic regression was used to predict the factors associated with a high treatment burden. SPSS V.26 was used for statistical analysis.
Results: A total of 256 participants were recruited (the median age was 64 years, and 39.1% were men). About 47% of participants had more than three chronic conditions, with hypertension (89.5%) and diabetes (82.0%) being the most common. Eighty-one percent of the participants had a high treatment burden with a median score of 40.4 (28.8–51.9). Arranging appointments (83.7%), seeing several health professionals (83.5%), and collecting prescription medicines (83.2%) were perceived as difficult tasks. Aspects related to treatment (collection of, taking, and paying for medicines) were the most difficult as perceived by participants. Low education (OR = 10.46; CI 3.01–36.39; P = 0.000), living outside Khartoum (OR = 4.24; CI 1.22–14.73; P = 0.023), having more chronic conditions (OR = 1.75; CI 1.03-2.97; P = 0.038), and taking more regular medications (OR = 1.32; CI 1.09–1.61; P = 0.004) were independently associated with high treatment burden.
Conclusion: A high treatment burden was common and was primarily incurred by difficulties in interacting with many healthcare providers and obtaining prescribed medicines. More attention should be given to assessing and supporting patients with multimorbidity to reduce the burden through organized and integrated healthcare services.