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Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness

Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness
Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness
Background
In this article we outline Burden of Treatment Theory, a new model of the relationship between sick people, their social networks, and healthcare services. Health services face the challenge of growing populations with long-term and life-limiting conditions, they have responded to this by delegating to sick people and their networks routine work aimed at managing symptoms, and at retarding – and sometimes preventing – disease progression. This is the new proactive work of patient-hood for which patients are increasingly accountable: founded on ideas about self-care, self-empowerment, and self-actualization, and on new technologies and treatment modalities which can be shifted from the clinic into the community. These place new demands on sick people, which they may experience as burdens of treatment.

Discussion
As the burdens accumulate some patients are overwhelmed, and the consequences are likely to be poor healthcare outcomes for individual patients, increasing strain on caregivers, and rising demand and costs of healthcare services. In the face of these challenges we need to better understand the resources that patients draw upon as they respond to the demands of both burdens of illness and burdens of treatment, and the ways that resources interact with healthcare utilization.

Summary
Burden of Treatment Theory is oriented to understanding how capacity for action interacts with the work that stems from healthcare. Burden of Treatment Theory is a structural model that focuses on the work that patients and their networks do. It thus helps us understand variations in healthcare utilization and adherence in different healthcare settings and clinical contexts.
1472-6963
May, Carl R.
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Eton, David T.
756ae8f2-18e5-4513-be43-715cca7e90ae
Boehmer, Kasey
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Gallacher, Katie
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Hunt, Katherine
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MacDonald, Sara
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Mair, Frances S.
303709c7-028a-44b9-b6da-e14f2d834f2b
May, Christine M.
227ab47a-1ca0-4437-905a-bd90feacc3d5
Montori, Victor
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Richardson, Alison
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Rogers, Anne E
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Shippee, Nathan
ddc64f0b-786b-4f36-9b0b-c2301a863a0c
May, Carl R.
17697f8d-98f6-40d3-9cc0-022f04009ae4
Eton, David T.
756ae8f2-18e5-4513-be43-715cca7e90ae
Boehmer, Kasey
02e83c0e-2f38-4a61-9fd7-a47923caa10e
Gallacher, Katie
0fa507fa-6432-4bdc-8fc2-5f427c279dfb
Hunt, Katherine
5eab8123-1157-4d4e-a7d9-5fd817218c6e
MacDonald, Sara
8d50c964-922c-4ae1-8bab-a2f5336b95ce
Mair, Frances S.
303709c7-028a-44b9-b6da-e14f2d834f2b
May, Christine M.
227ab47a-1ca0-4437-905a-bd90feacc3d5
Montori, Victor
e8fe1b97-b7f7-4aba-9111-add2f1811a72
Richardson, Alison
3db30680-aa47-43a5-b54d-62d10ece17b7
Rogers, Anne E
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Shippee, Nathan
ddc64f0b-786b-4f36-9b0b-c2301a863a0c

May, Carl R., Eton, David T., Boehmer, Kasey, Gallacher, Katie, Hunt, Katherine, MacDonald, Sara, Mair, Frances S., May, Christine M., Montori, Victor, Richardson, Alison, Rogers, Anne E and Shippee, Nathan (2014) Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness. BMC Health Services Research, 14 (1), [281]. (doi:10.1186/1472-6963-14-281).

Record type: Article

Abstract

Background
In this article we outline Burden of Treatment Theory, a new model of the relationship between sick people, their social networks, and healthcare services. Health services face the challenge of growing populations with long-term and life-limiting conditions, they have responded to this by delegating to sick people and their networks routine work aimed at managing symptoms, and at retarding – and sometimes preventing – disease progression. This is the new proactive work of patient-hood for which patients are increasingly accountable: founded on ideas about self-care, self-empowerment, and self-actualization, and on new technologies and treatment modalities which can be shifted from the clinic into the community. These place new demands on sick people, which they may experience as burdens of treatment.

Discussion
As the burdens accumulate some patients are overwhelmed, and the consequences are likely to be poor healthcare outcomes for individual patients, increasing strain on caregivers, and rising demand and costs of healthcare services. In the face of these challenges we need to better understand the resources that patients draw upon as they respond to the demands of both burdens of illness and burdens of treatment, and the ways that resources interact with healthcare utilization.

Summary
Burden of Treatment Theory is oriented to understanding how capacity for action interacts with the work that stems from healthcare. Burden of Treatment Theory is a structural model that focuses on the work that patients and their networks do. It thus helps us understand variations in healthcare utilization and adherence in different healthcare settings and clinical contexts.

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Accepted/In Press date: 16 June 2014
e-pub ahead of print date: 26 June 2014
Published date: 2014
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 366522
URI: http://eprints.soton.ac.uk/id/eprint/366522
ISSN: 1472-6963
PURE UUID: bb6fbf72-d9a4-47a1-a275-199641316c5f
ORCID for Carl R. May: ORCID iD orcid.org/0000-0002-0451-2690
ORCID for Katherine Hunt: ORCID iD orcid.org/0000-0002-6173-7319
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755

Catalogue record

Date deposited: 01 Jul 2014 16:16
Last modified: 25 Jun 2024 01:43

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Contributors

Author: Carl R. May ORCID iD
Author: David T. Eton
Author: Kasey Boehmer
Author: Katie Gallacher
Author: Katherine Hunt ORCID iD
Author: Sara MacDonald
Author: Frances S. Mair
Author: Christine M. May
Author: Victor Montori
Author: Anne E Rogers
Author: Nathan Shippee

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