多病患者的治疗负担:综合综述。

IF 2 Q2 MEDICINE, GENERAL & INTERNAL
Ji Eun Lee, Jihyang Lee, Rooheui Shin, Oonjee Oh, Kyoung Suk Lee
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引用次数: 0

摘要

背景:多病患者的治疗负担加重,可能导致不良的健康后果。尽管以前人们努力掌握治疗负担的概念,但对多病患者的治疗负担尚未进行深入探讨,这可能会限制我们对这一人群治疗负担的了解。本研究旨在确定多病患者治疗负担的构成要素、诱因和健康结果,从而绘制出多病患者治疗负担的综合地图。本研究的第二个目的是确定用于评估多病患者治疗负担的工具,并评估这些工具的全面性:本综合综述使用电子数据库 MEDLINE、EMBASE、CINAHL 和截至 2023 年 5 月的参考文献列表。所有以英语发表的实证研究,只要是探讨多病成人患者治疗负担的,均被纳入其中。采用预先确定的模板进行数据提取:本综述共纳入了 30 项研究。治疗负担包括四项医疗保健任务以及这些任务对多病症患者造成的社会、情感和经济影响。多重疾病的背景、个人情况以及可用的内部和外部资源如何影响治疗负担。我们探讨了治疗负担的增加会导致不坚持治疗、疾病进展、健康状况和生活质量下降以及照顾者的负担。我们使用了三种工具来测量多病共存者的治疗负担。这些工具在医疗保健任务和影响方面的全面程度各不相同。但是,没有一个项目涉及到持续确定任务优先次序的医疗保健任务:我们绘制了一张综合地图,说明了治疗负担、多病症背景、人们的资源和健康结果之间的关系。现有的测量方法都不包括询问在各种医疗保健任务中确定优先次序的持续过程的项目,这就凸显了改进测量方法的必要性。我们的研究结果加深了人们对多病症治疗负担的理解,但还需要更多的研究来加以完善。未来的研究还需要制定策略,以全面了解多病患者的医疗保健任务和影响,并采用综合方法减轻治疗负担,从而改善相关结果:DOI: https://doi.org/10.17605/OSF.IO/UF46V.
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment burden in multimorbidity: an integrative review.

Background: People living with multimorbidity experience increased treatment burden, which can result in poor health outcomes. Despite previous efforts to grasp the concept of treatment burden, the treatment burden of people living with multimorbidity has not been thoroughly explored, which may limit our understanding of treatment burden in this population. This study aimed to identify the components, contributing factors, and health outcomes of treatment burden in people with multiple diseases to develop an integrated map of treatment burden experienced by people living with multimorbidity. The second aim of this study is to identify the treatment burden instruments used to evaluate people living with multimorbidity and assess the comprehensiveness of the instruments.

Methods: This integrative review was conducted using the electronic databases MEDLINE, EMBASE, CINAHL, and reference lists of articles through May 2023. All empirical studies published in English were included if they explored treatment burden among adult people living with multimorbidity. Data extraction using a predetermined template was performed.

Results: Thirty studies were included in this review. Treatment burden consisted of four healthcare tasks and the social, emotional, and financial impacts that these tasks imposed on people living with multimorbidity. The context of multimorbidity, individual's circumstances, and how available internal and external resources affected treatment burden. We explored that an increase in treatment burden resulted in non-adherence to treatment, disease progression, poor health status and quality of life, and caregiver burden. Three instruments were used to measure treatment burden in living with multimorbidity. The levels of comprehensiveness of the instruments regarding healthcare tasks and impacts varied. However, none of the items addressed the healthcare task of ongoing prioritization of the tasks.

Conclusions: We developed an integrated map illustrating the relationships between treatment burden, the context of multimorbidity, people's resources, and the health outcomes. None of the existing measures included an item asking about the ongoing process of setting priorities among the various healthcare tasks, which highlights the need for improved measures. Our findings provide a deeper understanding of treatment burden in multimorbidity, but more research for refinement is needed. Future studies are also needed to develop strategies to comprehensively capture both the healthcare tasks and impacts for people living with multimorbidity and to decrease treatment burden using a holistic approach to improve relevant outcomes.

Trial registration: DOI: https://doi.org/10.17605/OSF.IO/UF46V.

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