Medication-related burden variation across chronic conditions: a population-based cross-sectional survey.

Abstract

Background: Medication therapy is an important healthcare intervention for patients with chronic conditions. Managing their own medication can place a burden known as medication-related burden (MRB) on the patients. The burden can vary among chronic conditions due to diverse medication and management needs. This study aimed to examine the variation in MRB across different chronic conditions in the adult general population.

Methods: This study was an online population-based cross-sectional survey conducted in 2021 representing Finnish adults aged 18-79 years. MRB was measured using a 13-item MRB instrument with a 5-point Likert scale, which is based on the 'Patients' lived experience with medicines' (PLEM) model. The instrument was divided into five dimensions: burden of medication routines; burden of medication characteristics; burden of adverse drug reactions; medication-related social burden; and healthcare-associated medication burden. The respondents were considered to have experienced MRB if they strongly agreed with at least one of the 13 items. Pearson's chi-square test was used for bivariate analyses between MRB and chronic conditions. Logistic regression analyses were performed to identify chronic conditions associated with MRB when adjusted for sociodemographic and health-related variables.

Results: Of the 2,081 respondents, 1,323 (63.6%) reported having at least one diagnosed chronic condition and using at least one prescription medication, thus forming the study population. Of them, 43.5% reported experiencing MRB. According to the multiple logistic regression model, diabetes (OR 1.77), heart disease (OR 1.53), rheumatic disease or other musculoskeletal disorders (OR 1.42), or other unspecified chronic conditions (OR 1.55) were associated with MRB (p < 0.05) when adjusted for demographic and health-related variables. The dimensions that contributed the most to MRB were the healthcare-associated medication burden (26.7%) and the burden of adverse drug reactions (21.5%).

Conclusions: MRB is rather common among people with chronic conditions, the prevalence varying according to the conditions. MRB was associated with diabetes, heart disease, and rheumatic disease. Identifying chronic conditions that increase the likelihood of MRB enables allocation of healthcare resources and planning of interventions to patients with those specific illnesses.