Treatment Burden Of Non-Communicable Diseases On Patients Attending Primary Health Care In Bahrain 2020: A Cross-Sectional Study

Background: Adaptation to chronic disease can be challenging. Compliance with medication, adjusting to lifestyle changes, attending health care facilities, and financial costs are among many obstacles encountered. Treatment burden is defined as the effort required by the patient or caregiver to manage the medical conditions of the patient and the impact that this has on their lives. The aim of this study was to help the health care system in establishing new strategies to address the treatment burden on patients with non-communicable diseases. Methods: A cross-sectional study was conducted among patients attending non-communicable disease clinics and central diabetic clinics in eight different primary health care centers in Bahrain, using the Treatment Burden Questionnaire through structured interviews. A value of 59 and above was considered as an unacceptable burden according to patient acceptable symptom state (PASS). Results: Of the 411 participants, around 18% had an unacceptable burden. Female subjects reported a five times higher treatment burden. The younger population of less than 65 years scored higher treatment burden by three folds. Injectable medications were associated with a two-fold increase in treatment burden compared to other medication modalities. Conclusion: Although treatment burden is an emerging and insufficiently addressed concept in the literature, this study revealed an overall low treatment burden. Further studies should be conducted to assess treatment burden and suggest strategies accordingly. Health care providers are encouraged to integrate all patient aspects in the management. New recommendations to formulate updated guidelines with the aim of minimizing the treatment burden are warranted. Keywords: Bahrain, Chronic disease, Non-communicable disease, Primary health care, Surveys and Questionnaires