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Treatment burden and treatment fatigue as barriers to health.
Open accessAbstract
Effective management of chronic diseases involves sustained changes in health behavior, which often requires substantial effort and patient burden. As treatment burden is associated with reduced adherence across several chronic conditions, its assessment and treatment are important clinical priorities. The balance between patient demands and capacity (e.g., coping resources) may be indexed by patients' subjective experience of treatment fatigue. We present a modified workload-capacity model that incorporates evidence that treatment fatigue may 1) be caused by increased workload due to treatment burden (e.g., intensity, complications) and 2) undermine adherence. Emerging technology-based interventions may be well-suited to reduce treatment burden, prevent treatment fatigue, and increase treatment adherence.
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“The term “treatment fatigue” has been researched in the context of HIV and type 1 diabetes, but it has not yet received attention in psychiatry.21”
From Establishing irremediable psychiatric suffering in the context of medical assistance in dying in the Netherlands: a qualitative study (2022) · cites this paper as [21]
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“Larger-than-expected reductions in resting and nonresting energy expenditure that occur with weight loss (ie, metabolic adaptation), compensatory changes in other homeostatic regulators of body weight, and patients' behavioral fatigue in adhering to diet and activity recommendations may contribute to the 5% to 10% weight reduction plateau observed with behavioral therapy.[23][24][25]”
From Effect of Subcutaneous Semaglutide vs Placebo as an Adjunct to Intensive Behavioral Therapy on Body Weight in Adults With Overweight or Obesity: The STEP 3 Randomized Clinical Trial (2021) · cites this paper as [24]
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“To date, research on treatment burden and treatment fatigue has largely centered on health behaviors such as medication adherence (Claborn et al., 2015) and exercise compliance in patients with chronic disease (Dobkin et al., 2005, 2006; Heckman et al., 2015).”
From Perception of Physical Demand, Mental Demand, and Performance: A Comparison of Two Voice Interventions for Parkinson's Disease (2022) · cites this paper as Heckman et al., 2015
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“Moreover, more is not always better, as patients may experience negative effects of overburden and treatment fatigue.30”
From Requests for Medical Assistance in Dying by Young Dutch People With Psychiatric Disorders (2025) · cites this paper as [30]
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“Although the intervention described above produced beneficial outcomes, its high intensity may limit its feasibility for some individuals with chronic stroke (31).”
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Metadata
- Authors
- Heckman, B. W., Mathew, A. R., & Carpenter, M. J.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- Heckman, Bryan W
- Venue
- Current Opinion in Psychology
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 5
- Pages
- 31-36
- ISSN
- 2352-250X (ISSN-L)
- PMC
- PMC4465180
- OpenAlex
- W2069363844
- Cited by
- 179
- References
- 46
- Citations by year
- 2026: 21 · 2025: 32 · 2024: 30 · 2023: 20 · 2022: 18 · 2021: 11 · 2020: 15 · 2019: 10 · 2018: 12 · 2017: 4 · 2016: 6
- FWCI
- 1.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Current Opinion in Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (T32 DA007288, F32 DA036947)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- treatment burden, treatment fatigue, medication adherence, chronic disease management, coping resources, health behavior change, patient burden
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