Measuring treatment burden with the treatment burden questionnaire (TBQ): a narrative literature review and implications for geriatric research and clinical practice

BACKGROUND: Treatment burden refers to the demands that healthcare places on a patient's daily life, including managing appointments, medications, and lifestyle adjustments. It is a critical concern for older adults, particularly those with multiple chronic conditions. High treatment burden has been associated with poorer treatment adherence, increased disruptions in care, and diminished quality of care. The Treatment Burden Questionnaire (TBQ) is a validated tool that has been successfully used to measure treatment burden in a variety of geographic, clinical, and research settings. METHODS: We conducted a narrative literature review to identify studies that have applied the TBQ in older adult populations and to examine how the instrument has been adapted for clinical and research use. Additionally, we explored considerations for its application in future studies assessing treatment burden in this population. RESULTS: The reviewed studies demonstrate the questionnaire's effectiveness across a wide range of clinical settings and patient populations. Findings indicate that treatment burden evolves over time and that combining the TBQ with other measures (e.g., frailty, symptom severity, medication adherence, and health literacy) yields a more comprehensive understanding of contributing factors. CONCLUSIONS: Strategic implementation of the TBQ, particularly alongside other patient-reported outcome measures and with attention to social determinants of health, can enhance its utility in clinical care and research involving older adults. Future research should prioritize combining TBQ measuring with other aging-specific factors, such as frailty, and incorporate qualitative methods to better capture the nuanced experiences of treatment burden in older adults.