Exploring the relationship between telehealth utilization and treatment burden among patients with chronic conditions: A cross-sectional study in Ontario, Canada

One in five Canadians lives with one or more chronic conditions. Patients with chronic conditions often experience a high treatment burden because of the work associated with managing care. Telehealth is considered a useful solution to reduce the treatment burden among patients with chronic conditions. However, telehealth can also increase the treatment burden by offloading responsibilities on patients. This cross-sectional study conducted in Ontario, Canada examines the association between telehealth utilization and treatment burden among patients with chronic conditions. This study aimed to explore whether and to what extent, telehealth use is associated with treatment burden among patients with chronic conditions. The secondary objective was to explore which sociodemographic variables are associated with patients’ treatment burden. An online survey was administered to community-dwelling patients with one or more chronic conditions. The Treatment Burden Questionnaire (TBQ-15) was used to measure the patient’s level of treatment burden, and a modified telehealth usage scale was developed and used to measure the frequency of telehealth use. Data was analyzed using descriptive statistics, correlations, analyses of variance, and hierarchical linear regression analysis. A total of 75 patients completed the survey. The participants’ mean age was 64 (SD = 18.93) and 79% were female. The average reported treatment burden was 72.15 out of 150 (a higher score indicating a higher level of burden). When adjusted for demographic variables, a higher frequency of telehealth use was associated with experiencing a higher treatment burden, but the association was not statistically significant. Additionally, when adjusted for demographic variables, younger age, and the presence of an unpaid caregiver were positively related to a high treatment burden score. This finding demonstrates that some patient populations are more at risk of experiencing high treatment burden in the context of telehealth use; and hence, may require extra support to utilize telehealth technologies. The study highlights the need for further research to explore how to minimize the treatment burden among individuals with higher healthcare needs.Author summary: Telehealth is considered as a promising solution to support patients with chronic conditions. However, using and adopting telehealth technologies can also increase/alleviate patients’ workload. This workload associated with healthcare use is called treatment burden. Currently, little is known about the relationship between telehealth use and treatment burden. Therefore, we conducted a study on how telehealth can make treatment burdens better or worse for these patients. Through our survey, we found that there is a positive association between high frequency of telehealth use and treatment burden. Our study shows that younger patients and patients without unpaid caregiver experience higher level of burden; and therefore, as a health system, we need to explore how to minimize treatment burden among this patient population through leveraging technologies and social services.