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• The scoping review explored the relationship between treatment burden and telehealth, focusing on chronic patients and their caregivers. • We conducted a review of 54 studies, finding that telehealth can both alleviate and exacerbate treatment burden. • Positive aspects include reduced travel time and costs, while challenges involve dealing with complex health data and adapting to new technology. • The findings of this study suggests that while introducing telehealth interventions, policymakers and clinicians should consider how to minimize patients' and their caregivers' treatment burden to enhance their care experience. Patients managing chronic conditions often face significant treatment burdens due to the long-term nature of their care. Treatment burden refers to the workload associated with the self-management of chronic conditions. While telehealth is commonly used to support these patients, there is a growing concern about its impact on marginalized patient populations. Specifically, we lack a comprehensive overview on how and what types of telehealth can increase or minimize the perceived treatment burden among this patient population. To synthesize evidence on the relationship between treatment burden and telehealth among patients with chronic conditions and their caregivers. We used Arksey and O'Malley's five-step scoping review framework to identify relevant literature that was published from January 2004 to May 2023. Fifty-four studies were included in the review. We identified various ways telehealth increases or minimizes patients' treatment burden. Some of the patient-reported benefits of telehealth regarding treatment burden were reducing time and cost associated with travel to the clinics. Conversely, some burdens associated with telehealth were making sense of the large volume of complex data generated by health technologies, and the extra work required to set up and learn about new technology. Review findings emphasize the importance of considering the concept of treatment burden while introducing telehealth-based interventions to support patients and their caregivers with chronic conditions. Future research needs to identify how to minimize the treatment burden associated with telehealth while implementing new telehealth interventions. [ABSTRACT FROM AUTHOR]

Frameworks for understanding integrated care risk underemphasizing the complexities of the development of integrated care in a local context. The objectives of this article are to (1) present a novel strategy for conceptualizing integrated care as developing through a series of milestones at the organizational level, and (2) present a typology of milestones empirically generated through the analysis of four cases of integrated community-based primary health care (ICBPHC) in Canada and New Zealand. Our paper reports on an analysis of 4 specific organizational case studies within a large dataset generated for an international multiple case study project of exemplar models of ICBPHC. Drawing on earlier analyses of 359 qualitative interviews with patients, caregivers, health care providers, managers, and policymakers, in this article we present a detailed analysis of 28 interviews with managers and leaders of local models of integrated care. We generated a detailed timeline of the development of integrated care as expressed by each participant, and synthesized themes across timelines within each case to identify specific milestone events. We then synthesized across cases to generate the broader milestone categories to which each event belongs. We generated 5 milestone categories containing 12 more specific milestone events. The milestone categories include (1) strategic relational, (2) strategic process change, (3) internal structural, (4) inter-organizational structural, and (5) external milestones. We propose a comprehensive framework of developmental milestones for integrated care. Milestones represent a compelling strategy for conceptualizing the development of integrated care. Practically, policymakers and health care leaders can support the implementation of integrated care by examining the history and context of a given model of care and identifying strategies to achieve milestones that will accelerate integrated care. Further research should document additional milestone events and advance the development of dynamic frameworks for integrated care. • Developmental milestones accelerate or decelerate achievement of integrated care. • 5 categories of milestones are identified. • A comprehensive framework for milestones of integrated care is proposed. • Implementation strategies should be based on past milestones achieved. [ABSTRACT FROM AUTHOR]