Engels Loes W S, van Merode Tiny, Heijmans Monique, Menting Juliane, Duncan Polly, Rademakers Jany
Department of Family Medicine, School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
Netherlands Institute for Health Services Research (Nivel), Utrecht, The Netherlands.
Fam Pract. 2024 Dec 2;41(6):901-908. doi: 10.1093/fampra/cmad100.
Multimorbidity is a growing problem. The number and complexity of (non-)pharmaceutical treatments create a great burden for patients. Treatment burden refers to the perception of the weight of these treatments, and is associated with multimorbidity. Measurement of treatment burden is of great value for optimizing treatment and health-related outcomes.
We aim to translate and validate the Multimorbidity Treatment Burden Questionnaire (MTBQ) for use in the Dutch population with multimorbidity and explore the level of treatment burden.
Translating the MTBQ into Dutch included forward-backward translation, piloting, and cognitive interviewing (n = 8). Psychometric properties of the questionnaire were assessed in a cross-sectional study of patients with multimorbidity recruited from a panel in the Netherlands (n = 959). We examined item properties, dimensionality, internal consistency reliability, and construct validity. The level of treatment burden in the population was assessed.
The mean age among 959 participants with multimorbidity was 69.9 (17-96) years. Median global NL-MTBQ score was 3.85 (interquartile range 0-9.62), representing low treatment burden. Significant floor effects were found for all 13 items of the instrument. Factor analysis supported a single-factor structure. The NL-MTBQ had high internal consistency (α = 0.845), and provided good evidence on the construct validity of the scale.
The Dutch version of the 13-item MTBQ is a single-structured, valid, and compact patient-reported outcome measure to assess treatment burden in primary care patients with multimorbidity. It could identify patients experiencing high treatment burden, with great potential to enhance shared decision-making and offer additional support.
共病问题日益严重。（非）药物治疗的数量和复杂性给患者带来了巨大负担。治疗负担指的是对这些治疗负担的感知，与共病相关。测量治疗负担对于优化治疗和健康相关结局具有重要价值。
我们旨在翻译并验证适用于荷兰共病患者群体的共病治疗负担问卷（MTBQ），并探索治疗负担水平。
将MTBQ翻译成荷兰语包括正向-反向翻译、预试验和认知访谈（n = 8）。在一项横断面研究中，对从荷兰一个小组招募的共病患者（n = 959）评估该问卷的心理测量学特性。我们检查了项目特性、维度、内部一致性信度和结构效度。评估了该人群的治疗负担水平。
959名共病参与者的平均年龄为69.9（17 - 96）岁。荷兰版MTBQ总体得分中位数为3.85（四分位间距0 - 9.62），表明治疗负担较低。该工具的所有13个项目均存在显著的地板效应。因子分析支持单因素结构。荷兰版MTBQ具有较高的内部一致性（α = 0.845），并为该量表的结构效度提供了良好证据。
13项的荷兰版MTBQ是一种单结构、有效且简洁的患者报告结局指标，用于评估基层医疗中共病患者的治疗负担。它可以识别出治疗负担高的患者，在增强共同决策和提供额外支持方面具有巨大潜力。
