Care burden 'makes patients ill'

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Some chronically ill patients are so overburdened by treatment that it makes their health worse, according to a new study in the BMJ medical journal.

The paper, by clinicians from Glasgow and Newcastle universities, says badly co-ordinated care leads to "wasted resources and poor outcomes".

It calls for more "minimally disruptive medicine" that is tailored to the realities of patients daily lives.

The findings of the paper are based on 10 years of research.

The paper, led by Carl May, professor of medical sociology at Newcastle University, states that patients can be burdened by much more than drug management and self monitoring.

We are calling for minimally disruptive medicine that seeks to tailor treatment regimens to the realities of the daily lives of patients Professor Frances MairGlasgow University

He said: "It includes organising doctors' visits and laboratory tests. Patients may also need to take on the organisational work of passing basic information about their care between different healthcare providers and professionals. "In some countries, they must also take on the contending demands of insurance and welfare agencies.

"Patients are thus overwhelmed not just by the burden of illness, but by the ever present and expanding burden of treatment."

The paper highlights cases where patients have suffered due to such a burden.

Among these cases is that of a man treated for heart failure who rejected the offer to attend a specialist heart failure clinic to improve his condition.

He said that over a two-year period he had made 54 individual visits to specialist clinics for consultant appointments, diagnostic tests and treatment - the equivalent of one full day every two weeks.

'Wasted resources'

Frances Mair, professor of primary care research at Glasgow University and co-author of the paper, said the findings showed the need for "better co-ordination of care".

"Thinking seriously about the burden of treatment may help us begin to consider minimally disruptive medicine - forms of effective treatment and service provision that are designed to reduce the burden of treatment on users," she said.

"The treatment burden leads to poor adherence, wasted resources and poor outcomes.

"We are calling for minimally disruptive medicine that seeks to tailor treatment regimens to the realities of the daily lives of patients.

"Such an approach could greatly improve the care and quality of life for patients."