Treatment Burden Discussion in Clinical Encounters: Priorities of COPD Patients, Carers and Physicians

Abstract

Many people with chronic obstructive pulmonary disease (COPD) feel overburdened with the treatment and management of their illness. Although research has begun to shed light on how COPD patients experience treatment burden, most of what we know is limited to personal experiences of patients. The aim of this study is to identify and prioritise areas of treatment burden that should be discussed during the clinical encounter from the perspectives of COPD patients, carers, and respiratory physicians. Patients and Methods: Data were collected from participants using the nominal group technique. Five nominal group sessions were conducted in total (n = 31); three sessions with patients (n = 18), one with carers (n = 7) and another with respiratory physicians (pulmonologists or chest physicians) (n = 6). Each session was recorded and analyzed using thematic analysis. Results: Going beyond understanding patients' and carers' experiences of treatment burden, this study offers a practical viewpoint of what should be discussed in a clinical encounter. Each group of participants contextualized treatment burden issues for discussion from their own perspectives. There was strong agreement, however, across the groups that difficulties accessing healthcare, lack of education and information, and worry about COPD treatment and prognosis were the most important treatment burden priorities for discussion. Conclusion: Understanding and creating opportunities to discuss these issues in a clinical encounter is important in not only reducing treatment burden but also improving health outcomes and quality of life for COPD patients and their carers.

Treatment burden in survivors of prostate and colorectal cancers: a qualitative interview study

“… 16 17 Having good social support or a caregiver can lower treatment burden for patients, 17 but caregivers can also become burdened. 18 19 The impact of treatment burden on informal caregivers is under-researched. 18 …”

“…Sav et al noted six key domains of treatment burden, encompassing ‘financial, medication, administrative, time/travel, lifestyle, and healthcare’ dimensions, and ‘antecedents’ which can influence the severity of treatment burden, such as age, gender, treatment characteristics and disease type 16 17. Having good social support or a caregiver can lower treatment burden for patients,17 but caregivers can also become burdened 18 19. The impact of treatment burden on informal caregivers is under-researched 18…”

30-Day Readmission Rate of Patients with COPD and Its Associated Factors: A Retrospective Cohort Study from a Tertiary Care Hospital

“…Sav et al reported that the treatment burden is high in patients with COPD, as the managing physicians not only need to prioritise the accessibility of healthcare to patients with COPD, but also worry about their treatment, prognosis, and medication-related burden. 26 Empowering especially respiratory therapist, Trained nurses and pharmacists as COPD educators and counsellors, as well as handing over to primary care physicians to educate patients about exacerbations and their risks, are some of the solutions to help reduce the burden of managing clinicians.…”