The DOI matches its Crossref record; 47 of the 47 references it cites were found in a registry or an index.
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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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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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In the citing paper
“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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Cites
Kirk, J. M. W., MacDonald, A., Lavender, P., Dean, J. M., & Rubin, G. (2017) · Biomedicine Hub · doi:10.1159/000480347 · Cited by 3,902
Interventions for enhancing medication adherence
Nieuwlaat, R., Wilczynski, N., Navarro, T., Hobson, N., Jeffery, R., Keepanasseril, A., Agoritsas, T., Mistry, N., Iorio, A., Jack, S., et al. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000011.pub4 · Cited by 2,945 · cited 1×
“Despite 182 randomized controlled trials (RCTs) of interventions designed to increase medication adherence, there is no clear solution [2].”
BackgroundFree, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., Patel, V., & Haines, A. (2013) · PLoS Medicine · doi:10.1371/journal.pmed.1001362 · Cited by 1,766
Assessing Psychosocial Distress in Diabetes
Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., & Jackson, R. A. (2005) · Diabetes Care · doi:10.2337/diacare.28.3.626 · Cited by 1,575
An opportunity cost model of subjective effort and task performance
Kurzban, R., Duckworth, A., Kable, J. W., & Myers, J. (2013) · Behavioral and Brain Sciences · doi:10.1017/s0140525x12003196 · Cited by 1,381
Why self-control seems (but may not be) limited
Inzlicht, M., Schmeichel, B. J., & Macrae, C. N. (2014) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2013.12.009 · Cited by 1,026
Mobile Health Technology Evaluation
Kumar, S., Nilsen, W. J., Abernethy, A., Atienza, A., Patrick, K., Pavel, M., Riley, W. T., Shar, A., Spring, B., Spruijt-Metz, D., et al. (2013) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2013.03.017 · Cited by 900
Shippee, N. D., Shah, N. D., May, C. R., Mair, F. S., & Montori, V. M. (2012) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2012.05.005 · Cited by 728
Mohr, D. C., Burns, M. N., Schueller, S. M., Clarke, G., & Klinkman, M. (2013) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2013.03.008 · Cited by 693
A Smartphone Application to Support Recovery From Alcoholism: A Randomized Clinical Trial
Gustafson, D. H., McTavish, F. M., Chih, M.-Y., Atwood, A. K., Johnson, R. A., Boyle, M. G., Levy, M. S., Driscoll, H., Chisholm, S. M., Dillenburg, L., et al. (2014) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.4642 · Cited by 692
Cited by
Sorted by citations
Nahum-Shani, I., Smith, S. N., Spring, B. J., Collins, L. M., Witkiewitz, K., Tewari, A., & Murphy, S. A. (2018) · Annals of Behavioral Medicine · doi:10.1007/s12160-016-9830-8 · Cited by 2,171
“Intervention fatigue A state of emotional or cognitive weariness associated with intervention engagement [13].”
BackgroundInfluentialDavies, M., Færch, L., Jeppesen, O. K., Pakseresht, A., Pedersen, S. D., Perreault, L., Rosenstock, J., Shimomura, I., Viljoen, A., Wadden, T. A., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00213-0 · Cited by 1,419
Wadden, T. A., Bailey, T. S., Billings, L. K., Davies, M., Frias, J. P., Koroleva, A., Lingvay, I., O’Neil, P. M., Rubino, D. M., Skovgaard, D., et al. (2021) · JAMA · doi:10.1001/jama.2021.1831 · Cited by 1,114
Kosiborod, M. N., Bhatta, M., Davies, M., Deanfield, J. E., Garvey, W. T., Khalid, U., Kushner, R., Rubino, D. M., Zeuthen, N., & Verma, S. (2023) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.14890 · Cited by 127
“Reducing medications used to treat obesity-related comorbidities lowers the treatment burden and may improve adherence to therapy.(34,35) The findings presented here generate the hypothesis that improvements in BP and lipid levels with semaglutide may translate into clinically meaningful changes that allow a reduction…”
BackgroundGruet, M. (2018) · Frontiers in Physiology · doi:10.3389/fphys.2018.01285 · Cited by 82
“It is also worth noting that cognitive failure has recently been demonstrated as an important predictor of elevated perceived fatigability (evaluated by the Fatigue Assessment Scale at baseline and then at 6 and 12 months) in patients with sarcoidosis (Hendriks et al., 2018).”
Background
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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