Treatment Burden Discussion in Clinical Encounters: Priorities of COPD Patients, Carers and Physicians

Abstract

Purpose

Many people with chronic obstructive pulmonary disease (COPD) feel overburdened with the treatment and management of their illness. Although research has begun to shed light on how COPD patients experience treatment burden, most of what we know is limited to personal experiences of patients. The aim of this study is to identify and prioritise areas of treatment burden that should be discussed during the clinical encounter from the perspectives of COPD patients, carers, and respiratory physicians.

Patients and Methods

Data were collected from participants using the nominal group technique. Five nominal group sessions were conducted in total (n = 31); three sessions with patients (n = 18), one with carers (n = 7) and another with respiratory physicians (pulmonologists or chest physicians) (n = 6). Each session was recorded and analyzed using thematic analysis.

Results

Going beyond understanding patients’ and carers’ experiences of treatment burden, this study offers a practical viewpoint of what should be discussed in a clinical encounter. Each group of participants contextualized treatment burden issues for discussion from their own perspectives. There was strong agreement, however, across the groups that difficulties accessing healthcare, lack of education and information, and worry about COPD treatment and prognosis were the most important treatment burden priorities for discussion.

Conclusion

Understanding and creating opportunities to discuss these issues in a clinical encounter is important in not only reducing treatment burden but also improving health outcomes and quality of life for COPD patients and their carers.

Keywords:

• COPD
• burden of treatment
• treatment burden
• nominal group technique

Acknowledgments

We would like to acknowledge Helen McEvoy with project management and Dr Bajee Krishna Sriram for assisting with recruitment. We would also like to thank all the participants for sharing their thoughts and priorities.

Disclosure

Adem Sav reports grants from Gold Coast Health Collaborative Research Grant Scheme, during the conduct of the study; and grants from the Gold Coast Health Collaborative Research Grant Scheme, outside the submitted work. Claudia C Dobler reports grants from Gold Coast Health and Australian National Health and Medical Research Council (NHMRC), during the conduct of the study. The authors report no other potential conflicts of interest in this work.

Additional information

Funding

This study was funded by a grant from the Gold Coast Health Collaborative Research Grant Scheme (application ID RGS20190034). CCD had salary support (independent of the study) from the Australian National Health and Medical Research Council (NHMRC) (application ID APP1123733).