Stroke and treatment burden

Question 1

What is treatment burden?

Answer 1

Workload of healthcare for individuals managing long term health conditions and the impact on wellbeing

Question 2

What does treatment burden arise as a consequence of?

Answer 2

• Workload volume - large number of medications, appointments, comorbidities
• Care deficiencies - appointments in different places at times that don’t work well for the patient, poor plan

Question 3

What is illness work?

Answer 3

The work that patients and their families do to understand and live with a chronic illness

Question 4

What is treatment work?

Answer 4

Tasks that need to be performed to manage health and follow treatments set by healthcare providers

Question 5

What can high levels of treatment burden lead to?

Answer 5

• Poor adherence
• Disengaging from health services
• Poorer quality of life

Question 6

What is patient capacity?

Answer 6

The degree to which patients can cope with management of their illness and their lives

Question 7

What is patient capacity affected by?

Answer 7

• Personal attributes and skills
• Support network
• Life workload
• Physical and cognitive abilities
• Environment

Question 8

Explain the cycle of overwhelming treatment burden

Answer 8

• Treatment burden leads to poor adherence
• poor adherence leads to worse health outcomes
• This results in escalated treatments from healthcare providers which then causes an increase to treatment burden

Question 9

What factors impact on treatment burden?

Answer 9

• Making sense of treatments and planning care (understanding, setting goals)
• Interacting with others (someone to take them to appointments, interaction with GP)
• Enacting management strategies
• Reflecting on the management (monitoring progress)

Question 10

What should you consider in someone who forgets to take their medications?

Answer 10

Dosette box

Question 11

What should you consider in someone struggling to collect their medications?

Answer 11

Get the pharmacy to deliver the medications

Question 12

What should you do for someone who is experiencing many side effects from their medications?

Answer 12

Medication review (should do this at least once a year regardless)

Question 13

What should you do about non attenders to hospital appointments?

Answer 13

• If they can’t get to the appointments then organise patient transport
• If they forget appointments then use reminder systems (text or letter)