Exploring treatment burden in people with type 2 diabetes mellitus (T2DM) in primary care settings

Introduction Treatment burden is the perceived workload of care by individuals. The treatment burden experienced by individuals with Type 2 Diabetes Mellitus (T2DM) is a major obstacle to achieving effective healthcare outcomes. The aim of this research is to facilitate better management of treatment burden in people with T2DM in primary care settings. Methods A systematic review, encompassing narrative analysis was used to characterise the treatment burden of T2DM and critical appraisal was used to identify the appropriate patient-reported outcome measures (PROMs) for measuring this burden. The selected instruments were employed with subsequent questionnaires, followed by patient focus groups. A convergent segregated approach was utilised to explore the T2DM treatment burden in China's primary care settings and to develop the conceptual framework of this burden, which contributed to qualitative data analysis in subsequent studies. An analysis of video recordings of consultations between general practitioners (GPs) and individuals with T2DM was conducted to identify current response approaches to the multifaceted issues related to this burden. Finally, GP focus groups involving a group decision-making process was facilitated, providing insights aimed at improving GP’s strategies for managing the T2DM treatment burdens in China's primary care settings. Results From the narrative review, a thematic framework for understanding the treatment burden of T2DM was developed. This framework underscores the complexity of this burden and guided the critical appraisal. The appraisal identified the treatment burden questionnaire (TBQ), the multimorbidity treatment burden questionnaire (MTBQ), and the patient experience with treatment and self-management (PETS) as the most robust PROMs. The TBQ was selected for the subsequent questionnaire, which found that treatment burden scores varied significantly according to individuals' socio[1]economic statuses. Qualitative insight was al