Measuring treatment burden related to general practice in patients with multimorbidity: development and validation of a PROM

Introduction This study aimed to either identify or develop and validate a patient-reported outcome measure (PROM) to assess treatment burden related to general practice for patients with multimorbidity, which can be used alongside the MultiMorbidity Questionnaire part 1 (MMQ1) without overwhelming...

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Main Authors: Per Kallestrup, Anne Frølich, Susanne Reventlow, Volkert Siersma, Anne Møller, Janus Laust Thomsen, Tora Grauers Willadsen, Jesper Bo Nielsen, Line Bjørnskov Pedersen, Henrik Larsen, Anne Holm, Anders Prior, Ann Dorrit Guassora, Mette Bech Risør, John Brandt Brodersen, Anna Bernhardt Lyhnebeck, Sussi Friis Buhl, Ann-Kathrin Lindahl Christiansen, John Sahl Andersen, Camilla Merrild, Frans Waldorff, Jens Søndergård, Jette Kolding Kristensen, Katrine Tranberg Jensen, Maria Haahr Nielsen, Marius Brostrøm Kousgaard, Sanne Lykke Lundstrøm, Sidsel Böcher, Sofie Rosenlund Lau, Zaza Kamper-Jørgensen, Kristine Henderson Bissenbakker, Mads Kristensen, Asger Waagepetersen, Anders Hye Dalsgaard, Anders Stockmar, Barbara Ann Barret, Elisabeth Søndergaard, Iben Charlotte Aaman, Kristine Bissenbacker, Mads Aage ToftKristensen, Maarten Pieter Rozing
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:Family Medicine and Community Health
Online Access:https://fmch.bmj.com/content/13/3/e003378.full
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author Per Kallestrup
Anne Frølich
Susanne Reventlow
Volkert Siersma
Anne Møller
Janus Laust Thomsen
Tora Grauers Willadsen
Jesper Bo Nielsen
Line Bjørnskov Pedersen
Henrik Larsen
Anne Holm
Anders Prior
Ann Dorrit Guassora
Mette Bech Risør
John Brandt Brodersen
Anna Bernhardt Lyhnebeck
Sussi Friis Buhl
Ann-Kathrin Lindahl Christiansen
John Sahl Andersen
Camilla Merrild
Frans Waldorff
Jens Søndergård
Jette Kolding Kristensen
Katrine Tranberg Jensen
Maria Haahr Nielsen
Marius Brostrøm Kousgaard
Sanne Lykke Lundstrøm
Sidsel Böcher
Sofie Rosenlund Lau
Zaza Kamper-Jørgensen
Kristine Henderson Bissenbakker
Mads Kristensen
Asger Waagepetersen
Anders Hye Dalsgaard
Anders Stockmar
Barbara Ann Barret
Elisabeth Søndergaard
Iben Charlotte Aaman
Kristine Bissenbacker
Mads Aage ToftKristensen
Maarten Pieter Rozing
author_facet Per Kallestrup
Anne Frølich
Susanne Reventlow
Volkert Siersma
Anne Møller
Janus Laust Thomsen
Tora Grauers Willadsen
Jesper Bo Nielsen
Line Bjørnskov Pedersen
Henrik Larsen
Anne Holm
Anders Prior
Ann Dorrit Guassora
Mette Bech Risør
John Brandt Brodersen
Anna Bernhardt Lyhnebeck
Sussi Friis Buhl
Ann-Kathrin Lindahl Christiansen
John Sahl Andersen
Camilla Merrild
Frans Waldorff
Jens Søndergård
Jette Kolding Kristensen
Katrine Tranberg Jensen
Maria Haahr Nielsen
Marius Brostrøm Kousgaard
Sanne Lykke Lundstrøm
Sidsel Böcher
Sofie Rosenlund Lau
Zaza Kamper-Jørgensen
Kristine Henderson Bissenbakker
Mads Kristensen
Asger Waagepetersen
Anders Hye Dalsgaard
Anders Stockmar
Barbara Ann Barret
Elisabeth Søndergaard
Iben Charlotte Aaman
Kristine Bissenbacker
Mads Aage ToftKristensen
Maarten Pieter Rozing
collection DOAJ
description Introduction This study aimed to either identify or develop and validate a patient-reported outcome measure (PROM) to assess treatment burden related to general practice for patients with multimorbidity, which can be used alongside the MultiMorbidity Questionnaire part 1 (MMQ1) without overwhelming the target population with redundant items.Methods We conducted a systematic literature review to identify all existing PROMs measuring treatment burden. If no suitable PROM was found, our plan was to: (1) develop a draft PROM using items from existing instruments, (2) carry out group and individual interviews with patients with multimorbidity to ensure the PROM’s understandability, clarity, completeness and relevance and (3) undertake psychometric validation with a diverse sample of primary care patients with chronic conditions.Results We did not identify an eligible PROM in the literature review. The draft PROM consisted of 30 items divided into six domains; Information about treatment, Challenges with medication, Medical appointments, Self-monitoring, Health behaviour and Challenges in the contact to the health system. In the psychometric validation, neither these domains nor any other theoretical constellation of items had adequate psychometric properties. Individual items had good criterion validity and sensitivity to change.Conclusions In this study, we developed a 30-item PROM with high content validity where various individual items showed adequate criterion validity and sensitivity to change, making these items useful as a supplemental measure to the MMQ1.Trial registration number NCT05676541 Registration Date: 16 December 2022.
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spelling doaj-art-de103518d00c48ddb93098b5533d5ae32025-08-20T04:02:50ZengBMJ Publishing GroupFamily Medicine and Community Health2305-69832009-87742025-08-0113310.1136/fmch-2025-003378Measuring treatment burden related to general practice in patients with multimorbidity: development and validation of a PROM 0Per KallestrupAnne FrølichSusanne ReventlowVolkert Siersma1Anne Møller2Janus Laust ThomsenTora Grauers WilladsenJesper Bo NielsenLine Bjørnskov PedersenHenrik LarsenAnne Holm3Anders Prior4Ann Dorrit GuassoraMette Bech RisørJohn Brandt Brodersen5Anna Bernhardt Lyhnebeck6Sussi Friis Buhl7Ann-Kathrin Lindahl ChristiansenJohn Sahl AndersenCamilla MerrildFrans WaldorffJens SøndergårdJette Kolding Kristensen8Katrine Tranberg JensenMaria Haahr NielsenMarius Brostrøm KousgaardSanne Lykke LundstrømSidsel Böcher9Sofie Rosenlund LauZaza Kamper-Jørgensen10Kristine Henderson Bissenbakker11Mads Kristensen12Asger Waagepetersen13Anders Hye Dalsgaard14Anders StockmarBarbara Ann BarretElisabeth SøndergaardIben Charlotte AamanKristine BissenbackerMads Aage ToftKristensenMaarten Pieter RozingDepartments of Urology and Radiology, Radboud University Medical Center, Nijmegen, Gelderland, The NetherlandsUniversity of Copenhagen, Research Unit for General Practice, Copenhagen, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkAarhus University Research Unit for General Practice, Aarhus, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkDepartment of Public Health, University of Southern Denmark Research Unit of General Practice, Odense, DenmarkDepartment of Clinical, Aalborg Universitet, Aalborg, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkDepartment of Public Health, University of Copenhagen Centre of General Practice, Copenhagen, DenmarkIntroduction This study aimed to either identify or develop and validate a patient-reported outcome measure (PROM) to assess treatment burden related to general practice for patients with multimorbidity, which can be used alongside the MultiMorbidity Questionnaire part 1 (MMQ1) without overwhelming the target population with redundant items.Methods We conducted a systematic literature review to identify all existing PROMs measuring treatment burden. If no suitable PROM was found, our plan was to: (1) develop a draft PROM using items from existing instruments, (2) carry out group and individual interviews with patients with multimorbidity to ensure the PROM’s understandability, clarity, completeness and relevance and (3) undertake psychometric validation with a diverse sample of primary care patients with chronic conditions.Results We did not identify an eligible PROM in the literature review. The draft PROM consisted of 30 items divided into six domains; Information about treatment, Challenges with medication, Medical appointments, Self-monitoring, Health behaviour and Challenges in the contact to the health system. In the psychometric validation, neither these domains nor any other theoretical constellation of items had adequate psychometric properties. Individual items had good criterion validity and sensitivity to change.Conclusions In this study, we developed a 30-item PROM with high content validity where various individual items showed adequate criterion validity and sensitivity to change, making these items useful as a supplemental measure to the MMQ1.Trial registration number NCT05676541 Registration Date: 16 December 2022.https://fmch.bmj.com/content/13/3/e003378.full
spellingShingle Per Kallestrup
Anne Frølich
Susanne Reventlow
Volkert Siersma
Anne Møller
Janus Laust Thomsen
Tora Grauers Willadsen
Jesper Bo Nielsen
Line Bjørnskov Pedersen
Henrik Larsen
Anne Holm
Anders Prior
Ann Dorrit Guassora
Mette Bech Risør
John Brandt Brodersen
Anna Bernhardt Lyhnebeck
Sussi Friis Buhl
Ann-Kathrin Lindahl Christiansen
John Sahl Andersen
Camilla Merrild
Frans Waldorff
Jens Søndergård
Jette Kolding Kristensen
Katrine Tranberg Jensen
Maria Haahr Nielsen
Marius Brostrøm Kousgaard
Sanne Lykke Lundstrøm
Sidsel Böcher
Sofie Rosenlund Lau
Zaza Kamper-Jørgensen
Kristine Henderson Bissenbakker
Mads Kristensen
Asger Waagepetersen
Anders Hye Dalsgaard
Anders Stockmar
Barbara Ann Barret
Elisabeth Søndergaard
Iben Charlotte Aaman
Kristine Bissenbacker
Mads Aage ToftKristensen
Maarten Pieter Rozing
Measuring treatment burden related to general practice in patients with multimorbidity: development and validation of a PROM
Family Medicine and Community Health
title Measuring treatment burden related to general practice in patients with multimorbidity: development and validation of a PROM
title_full Measuring treatment burden related to general practice in patients with multimorbidity: development and validation of a PROM
title_fullStr Measuring treatment burden related to general practice in patients with multimorbidity: development and validation of a PROM
title_full_unstemmed Measuring treatment burden related to general practice in patients with multimorbidity: development and validation of a PROM
title_short Measuring treatment burden related to general practice in patients with multimorbidity: development and validation of a PROM
title_sort measuring treatment burden related to general practice in patients with multimorbidity development and validation of a prom
url https://fmch.bmj.com/content/13/3/e003378.full
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