Evidence map›Paper›PMID 24969758›Full record

ArticleBMC health services research2014

Rethinking the patient: using Burden of Treatment Theory to understand the changing dynamics of illness.

Carl R May, David T Eton, Kasey Boehmer, Katie Gallacher, Katherine Hunt, Sara MacDonald, Frances S Mair, Christine M May, Victor M Montori, Alison Richardson and 2 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07451587 (Multicenter Mixed-Methods Pilot Study Evaluating a Personalized Care Management Model), which is not on this map. Cited by 394 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
394citing papers in PubMed, 10 pooled it
64.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07451587 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Multicenter Mixed-Methods Pilot Study Evaluating a Personalized Care Management Model (GAP-421) for Chronic Pain in Primary Care Physiotherapy: Feasibility, Care Coordination, and Patient-Reported Outcomes

TypeinterventionalSponsorUniversidad Autonoma de MadridRan2026 to 2029Enrolled66ConditionsChronic Pain, Chronic Non-cancer Pain, Care Coordination, Primary Health CareArmsGAP-421 Personalized Care Management Model
3 · Its place in the literature

Who cites it

394 citing papers in PubMed, 10 syntheses or guidelines pooled it, 706 citations in OpenAlex.

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  9. Influence of health-system change on treatment burden: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
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  15. Treatment burden for people experiencing homelessness with a recent non-fatal overdose: a questionnaire study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023
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  19. Clinical empathy and relational continuity mitigate care fragmentation for patients with multiple long-term conditions: a qualitative study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
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334 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 6 institutions in 2 countries.

Carl R MayFaculty of Health Sciences, University of Southampton, Building 67 (Nightingale), University Road, Highfield, Southampton SO17 1BJ, UK. c.r.may@soton.ac.uk.
David T Eton
Kasey Boehmer
Katie Gallacher
Katherine Hunt
Sara MacDonald
Frances S Mair
Christine M May
Victor M Montori
Alison Richardson
Anne E Rogers
Nathan Shippee
University of Glasgow · GBUniversity of Southampton · GBMayo Clinic in Florida · USNational Institute for Health Research · GBMayo Clinic in Arizona · USUniversity of Minnesota · US

Funding

Chief Scientist Office
6 · The paper itself

Abstract

backgroundIn this article we outline Burden of Treatment Theory, a new model of the relationship between sick people, their social networks, and healthcare services. Health services face the challenge of growing populations with long-term and life-limiting conditions, they have responded to this by delegating to sick people and their networks routine work aimed at managing symptoms, and at retarding - and sometimes preventing - disease progression. This is the new proactive work of patient-hood for which patients are increasingly accountable: founded on ideas about self-care, self-empowerment, and self-actualization, and on new technologies and treatment modalities which can be shifted from the clinic into the community. These place new demands on sick people, which they may experience as burdens of treatment. DISCUSSION: As the burdens accumulate some patients are overwhelmed, and the consequences are likely to be poor healthcare outcomes for individual patients, increasing strain on caregivers, and rising demand and costs of healthcare services. In the face of these challenges we need to better understand the resources that patients draw upon as they respond to the demands of both burdens of illness and burdens of treatment, and the ways that resources interact with healthcare utilization. SUMMARY: Burden of Treatment Theory is oriented to understanding how capacity for action interacts with the work that stems from healthcare. Burden of Treatment Theory is a structural model that focuses on the work that patients and their networks do. It thus helps us understand variations in healthcare utilization and adherence in different healthcare settings and clinical contexts.

Indexed as

Cost of IllnessModels, TheoreticalSelf CareDisease ProgressionHealth ServicesHumansSocial Support

Identifiers

PMID24969758
PMCPMC4080515
OpenAlexW2167877406

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.