The Treatment Burden for Multimorbidity Scale: A Development and Psychometric Validation Study.

Area of Science:

• Health Services Research
• Patient-Reported Outcomes
• Clinical Measurement

Background:

• Existing instruments inadequately capture the comprehensive treatment burden associated with multimorbidity.
• Managing multiple chronic conditions presents significant challenges for patients, impacting their daily lives and healthcare engagement.

Purpose of the Study:

• To develop and validate a new, reliable, and valid measure for assessing treatment burden in patients with multimorbidity.
• To establish the psychometric properties, including reliability, validity, and responsiveness, of the Treatment Burden for Multimorbidity Scale (TBMS).

Main Methods:

• Development of the TBMS based on literature review and existing instruments, followed by content validity evaluation with experts and patients.
• Psychometric testing using a longitudinal survey design with data from 503 patients at baseline and 313 at 6-month follow-up.
• Analysis of reliability (Cronbach's alpha), construct validity (correlations with related measures), and responsiveness to change over time.

Main Results:

• The final 12-item TBMS demonstrated strong internal consistency (Cronbach's alpha = 0.93) and factor structure reflecting healthcare tasks and impacts.
• TBMS scores showed significant correlations with disease burden, existing multimorbidity treatment burden measures, and self-care, supporting construct validity.
• Changes in TBMS scores over 6 months were associated with changes in self-care, depressive symptoms, physical function, and self-rated health, indicating responsiveness.

Conclusions:

• The Treatment Burden for Multimorbidity Scale (TBMS) is a reliable, valid, and responsive instrument for assessing treatment burden in patients with multiple chronic conditions.
• The TBMS provides a valuable tool for clinicians and researchers to better understand and manage the complexities of multimorbidity treatment.
• This new scale can inform clinical practice and healthcare interventions aimed at reducing the treatment burden for individuals managing multiple health issues.