Treatment Burden and Chronic Illness: Who is at Most Risk?
Treatment Burden and Chronic Illness: Who is at Most Risk?
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DOI：
10.1007/s40271-016-0175-y
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发表时间：
2016-12-01
影响因子：
3.6
通讯作者：
Wheeler, Amanda J.
中科院分区：
文献类型：
--
作者：
Sav, Adem;Whitty, Jennifer A.;Wheeler, Amanda J.
有必要确定患有共病的人所经历的治疗负担的类型和水平。这对于确定治疗负担风险最大的参与者的特征很重要。本研究的目的是确定治疗负担风险最大的参与者的特征。这项横断面研究是一个更大的项目的一部分，招募工作在澳大利亚的四个地区进行：农村、半农村和大都市。参与者被问及他们的治疗负担，使用的是经过调整的测量版本，其中包括以下五个维度：药物、时间和行政、生活方式的改变、社会生活和经济负担。总共有581名患有各种慢性健康状况的参与者报告了全球平均治疗负担56.5分(标准差=34.5)。慢性疾病的数量(Beta=.34，p<；0.01)、年龄(Beta=-.27，p<；0.01)、有无报酬的照顾者(Beta=.22，p<；0.001)以及糖尿病和其他内分泌疾病(Beta=.13，p<；0.01)是总体治疗负担的重要预测因素。对于治疗负担的五个维度，社会、药物和行政负担由同一组变量预测：病情数量、年龄、是否有无报酬的照顾者和糖尿病。然而，除了这些变量外，教育水平、种族和医疗保险也对财务维度进行了预测。教育水平也影响生活方式的负担。相当大比例的慢性病社区成年人有相当程度的治疗负担。具体地说，卫生专业人员应更加注重管理年轻、有内分泌疾病或无偿照顾者或这些因素的组合的人的总体治疗负担。
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.The aim of this study is to identify the characteristics of participants who are at most risk of treatment burden.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.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 (beta = .34, p < 0.01), age, (beta = -.27, p < 0.01), the presence of an unpaid carer (beta = .22, p < 0.001) and the presence of diabetes mellitus and other endocrine conditions (beta = .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.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.