Factors Associated with Treatment Burden in Older Adults with Multimorbidity and Implications for Potential Reduction Strategies: A Scoping Review

Vollständiger Abstract

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Background: Treatment Burden (TB) refers to the workload imposed on patients by healthcare-related tasks involved in the management of chronic conditions. Despite increasing evidence on this phenomenon, strategies for its reduction in older adults with multimorbidity remain poorly explored. Aim: To map the factors associated with treatment burden reported for older patients with multimorbidity and to derive implications for potential reduction strategies, regardless of the care setting. Methods: A scoping review was conducted applying the JBI methodology for scoping reviews and reported in accordance with the PRISMA-ScR checklist. The literature search was performed on PubMed, Scopus, and CINAHL; no restrictions on publication year or language were applied. All study designs were eligible if they reported factors associated with TB from which reduction strategies could be derived, in patients aged ≥65 years, or with a mean age ≥ 65 years, with multimorbidity or associated geriatric conditions. Results: Six studies met the eligibility criteria, all of which were observational in design, conducted between 2021 and 2025. Eleven potential strategies for TB reduction, inferred from observational findings, were identified and grouped into three areas: healthcare system and access to care, therapeutic regimen, and patient and psychosocial context. Conclusions: To our knowledge, this review provides the first structured mapping of potential TB reduction strategies specifically in the older population with multimorbidity. The identified strategies, derived by the authors rather than empirically tested, may exclusively inform the design of future interventional studies and offer healthcare professionals preliminary guidance for TB management in this population.