Document Type
Journal Article
Publication Title
BMC Primary Care
Volume
25
Issue
1
PubMed ID
38858619
Publisher
Springer
School
School of Medical and Health Sciences / School of Nursing and Midwifery
RAS ID
70308
Funders
Basic and Applied Basic Research Foundation of Guangdong Province / the Special Funds for Science and Technology of Guangdong Province / the Medical Science and Technology Research Fund Project of Guangdong Province / the Education Science Research Programme
Grant Number
210715106900989, 2023A1515010358, STKJ2023007, 210713116871875, A2023422, 2022GXJK195
Abstract
Background: Measuring treatment burden is important for the effective management of Type 2 Diabetes Mellitus (T2DM) care. The purpose of this systematic review was to identify the most robust approach for measuring treatment burden in people with T2DM based on existing evidence. Methods: Articles from seven databases were retrieved. Qualitative, quantitative, and mixed-methods studies examining treatment burden in adults with T2DM and/or reporting relevant experiences were included. A convergent segregated approach with a mixed-methods design of systematic review was employed, creating a measurement framework in a narrative review for consistent critical appraisal. The quality of included studies was assessed using the Joanna Briggs Institute tool. The measurement properties of the instruments were evaluated using the Consensus based Standards for selection of Health Measurement Instruments (COSMIN) checklist. Results: A total of 21,584 records were screened, and 26 articles were included, comprising 11 quantitative, 11 qualitative, and 4 mixed-methods studies. A thematic analysis of qualitative data extracted from the included articles summarised a measurement framework encompassing seven core and six associated measurements. The core measurements, including financial, medication, administrative, lifestyle, healthcare, time/travel, and medical information burdens, directly reflect the constructs pertinent to the treatment burden of T2DM. In contrast, the associated measurement themes do not directly reflect the burdens or are less substantiated by current evidence. The results of the COSMIN checklist evaluation demonstrated that the Patient Experience with Treatment and Self-management (PETS), Treatment Burden Questionnaire (TBQ), and Multimorbidity Treatment Burden Questionnaire (MTBQ) have robust instrument development processes. These three instruments, with the highest total counts combining the number of themes covered and "positive" ratings in COSMIN evaluation, were in the top tertile stratification, demonstrating superior applicability for measuring T2DM treatment burden. Conclusions: This systematic review provides evidence for the currently superior option of measuring treatment burden in people with T2DM. It also revealed that most current research was conducted in well-resourced institutions, potentially overlooking variability in under-resourced settings.
DOI
10.1186/s12875-024-02461-x
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Lin, K., Yao, M., Ji, X., Li, R., Andrew, L., Oosthuizen, J., ... & Chen, Y. (2024). Measuring treatment burden in people with Type 2 Diabetes Mellitus (T2DM): a mixed-methods systematic review. BMC Primary Care, 25(1), 206. https://doi.org/10.1186/s12875-024-02461-x