Abstract
Background & Purpose: Patients with multimorbidity experience unique challenges in performing self-care due to the complexity of dealing with multiple diseases simultaneously. The burden of managing multiple conditions and its impact on patients’ well-being (i.e., multimorbidity treatment burden) can negatively affect their ability to engage in recommended self-care regimens. While most studies have focused on disease burden, an outcome of disease progression that is often less modifiable, the relationship between multimorbidity treatment burden and self-care remains less explored. Therefore, the purpose of this study was to determine whether multimorbidity treatment burden was an independent predictor of self-care in patients with hypertension and additional chronic conditions.
Methods: This cross-sectional study included 503 patients who had hypertension and at least two comorbidities. Multimorbidity treatment burden was measured using the Treatment Burden for Multimorbidity Scale, and disease burden was measured using a self-report instrument that evaluates the extent to which each condition limits daily activities. Self-care was measured with the Partners in Health Scale. Hierarchical regression analysis was conducted to evaluate the extent to which multimorbidity treatment burden explained self-care after adjusting for disease burden and covariates. The first model (Model 1) included age, sex, living arrangement, employment status, social support, and health literacy as covariates. Model 2 added disease burden, and Model 3 included all covariates, disease burden, and multimorbidity treatment burden.
Results: In Model 3, multimorbidity treatment burden and disease burden predicted self-care (β=-0.18, p< 0.001 and β=0.10, p< 0.001, respectively), with greater multimorbidity treatment burden and lower disease burden associated with poorer self-care. The Model 3 explained 21.6% of variance in self-care, with multimorbidity treatment burden accounting for 2.0% of variance (adjusted R2 change = 0.02).
Conclusion: We found that both multimorbidity treatment burden and disease burden predicted self-care. However, as disease burden is often non-modifiable, multimorbidity treatment burden is a modifiable target for intervention to improve self-care in multimorbid patients with hypertension. Thus, interventions aimed at alleviating multimorbidity treatment burden may effectively improve self-care in this population.
Notes
References:
1. Bourbeau, J., Saad, N., Joubert, A., Ouellet, I., Drouin, I., Lombardo, C., Paquet, F., Beaucage, D., & Lebel, M. (2013). Making collaborative self-management successful in COPD patients with high disease burden. Respiratory medicine, 107(7), 1061-1065.
2. Bringsvor, H. B., Skaug, K., Langeland, E., Oftedal, B. F., Assmus, J., Gundersen, D., Osborne, R. H., & Bentsen, S. B. (2018). Symptom burden and self-management in persons with chronic obstructive pulmonary disease. International journal of chronic obstructive pulmonary disease, 365-373.
3. Corbett, T., Lee, K., Cummings, A., Calman, L., Farrington, N., Lewis, L., ... & Bridges, J. (2022). Self-management by older people living with cancer and multi-morbidity: a qualitative study. Supportive Care in Cancer, 30(6), 4823-4833.
4. Eton, D. T., Linzer, M., Boehm, D. H., Vanderboom, C. E., Rogers, E. A., Frost, M. H., ... & Anderson, R. T. (2020). Deriving and validating a brief measure of treatment burden to assess person-centered healthcare quality in primary care: a multi-method study. BMC Family Practice, 21, 1-17.
5. Eton, D. T., Yost, K. J., Lai, J. S., Ridgeway, J. L., Egginton, J. S., Rosedahl, J. K., ... & Anderson, R. T. (2017). Development and validation of the Patient Experience with Treatment and Self-management (PETS): a patient-reported measure of treatment burden. Quality of Life Research, 26, 489-503.
6. Ørtenblad, L., Meillier, L., & Jønsson, A. R. (2018). Multi-morbidity: a patient perspective on navigating the health care system and everyday life. Chronic Illness, 14(4), 271-282.
7. Schreiner, N., DiGennaro, S., Harwell, C., Burant, C., Daly, B., & Douglas, S. (2020). Treatment burden as a predictor of self-management adherence within the primary care population. Appl Nurs Res, 54, 151301. https://doi.org/10.1016/j.apnr.2020.151301
8. Tran, V. T., Montori, V. M., & Ravaud, P. (2020, March). Is my patient Overwhelmed?: determining thresholds for acceptable burden of treatment using data from the compare e-Cohort. In Mayo Clinic Proceedings (Vol. 95, No. 3, pp. 504-512). Elsevier.
Sigma Membership
Non-member
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Other
Keywords:
Primary Care, Hypertension, Patients with Multimorbidity, Treatments, Self-care
Recommended Citation
Yoo, Hyerin; Lee, Jihyang; and Lee, Kyoung Suk, "Multimorbidity Treatment Burden Predicts Self-Care in Multimorbid Patients With Hypertension" (2025). International Nursing Research Congress (INRC). 135.
https://www.sigmarepository.org/inrc/2025/presentations_2025/135
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Multimorbidity Treatment Burden Predicts Self-Care in Multimorbid Patients With Hypertension
Seattle, Washington, USA
Background & Purpose: Patients with multimorbidity experience unique challenges in performing self-care due to the complexity of dealing with multiple diseases simultaneously. The burden of managing multiple conditions and its impact on patients’ well-being (i.e., multimorbidity treatment burden) can negatively affect their ability to engage in recommended self-care regimens. While most studies have focused on disease burden, an outcome of disease progression that is often less modifiable, the relationship between multimorbidity treatment burden and self-care remains less explored. Therefore, the purpose of this study was to determine whether multimorbidity treatment burden was an independent predictor of self-care in patients with hypertension and additional chronic conditions.
Methods: This cross-sectional study included 503 patients who had hypertension and at least two comorbidities. Multimorbidity treatment burden was measured using the Treatment Burden for Multimorbidity Scale, and disease burden was measured using a self-report instrument that evaluates the extent to which each condition limits daily activities. Self-care was measured with the Partners in Health Scale. Hierarchical regression analysis was conducted to evaluate the extent to which multimorbidity treatment burden explained self-care after adjusting for disease burden and covariates. The first model (Model 1) included age, sex, living arrangement, employment status, social support, and health literacy as covariates. Model 2 added disease burden, and Model 3 included all covariates, disease burden, and multimorbidity treatment burden.
Results: In Model 3, multimorbidity treatment burden and disease burden predicted self-care (β=-0.18, p< 0.001 and β=0.10, p< 0.001, respectively), with greater multimorbidity treatment burden and lower disease burden associated with poorer self-care. The Model 3 explained 21.6% of variance in self-care, with multimorbidity treatment burden accounting for 2.0% of variance (adjusted R2 change = 0.02).
Conclusion: We found that both multimorbidity treatment burden and disease burden predicted self-care. However, as disease burden is often non-modifiable, multimorbidity treatment burden is a modifiable target for intervention to improve self-care in multimorbid patients with hypertension. Thus, interventions aimed at alleviating multimorbidity treatment burden may effectively improve self-care in this population.
Description
We explored whether multimorbidity treatment burden was an independent predictor of self-care in patients with hypertension and additional chronic conditions. Hierarchical regression analysis was conducted after adjusting for disease burden and covariates. This study emphasizes that while disease burden is often unmodifiable, multimorbidity treatment burden is a modifiable target for intervention to improve self-care in this population.