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Validation of a novel patient-reported measure of the burden of digital care in diabetes
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Validation of a novel patient-reported measure of the burden of digital care in diabetes
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Journal Article
Validation of a novel patient-reported measure of the burden of digital care in diabetes
2025
Overview
Background
Patients living with diabetes and chronic conditions may face a significant burden managing their health. Many of these patients use digital medicine tools such as continuous glucose monitoring systems. Although measures exist to assess treatment burden from tasks such as managing medications and attending healthcare visits, there is no patient-reported measure that captures the burden of digital care. Therefore, the purpose of this study is to validate the Treatment Burden Questionnaire Plus Digital (TBQ + D), a patient-reported measure of treatment burden that includes using digital tools for adults with diabetes.
Methods
Adult patients with type 1 or type 2 diabetes mellitus completed the 25-item TBQ + D (scored 0 [none] to 10 [maximum] per item, total score range 0–250). We evaluated ease of administration, internal consistency, and tested hypotheses about the relationship between TBQ + D scores and treatment complexity, digital tool use intensity, social risk factors, and digital comfort to assess TBQ + D’s validity.
Results
Of 324 patients approached, 300 (93%) consented and completed the TBQ + D (mean age 57 [
SD
17], 50% female, 50% with type 2). The mean TBQ + D score was 53.7 (
SD
41.6). Internal consistency was excellent (Cronbach’s
α
= 0.94). As hypothesized, higher TBQ + D scores were reported by patients with type 1 vs. type 2 diabetes mellitus (61.7 vs. 45.7,
p
= .0008), maximal/moderate vs. minimal to no digital tool use (56.5/60.7 vs. 41.3,
p
= .001), those on intensive insulin therapy vs. other treatments (61.4 vs. 38.0,
p
< .0001), and those with greater social vulnerability (
p
< .0106). TBQ + D scores were not significantly higher in patients with HbA1c ≥ 8% (
p
= .055) or less comfortable with digital technology (
p
= .08).
Conclusions
TBQ + D is a novel and valid measure of treatment burden in patients living with diabetes, inclusive of digital burden, which can play a role in fostering minimally disruptive care for patients with diabetes.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Aged
/ Blood Glucose Self-Monitoring
/ Diabetes
/ Diabetes mellitus (insulin dependent)
/ Diabetes mellitus (non-insulin dependent)
/ Diabetes Mellitus, Type 1 - therapy
/ Diabetes Mellitus, Type 2 - therapy
/ Female
/ Humans
/ Insulin
/ Male
/ Medicine
/ Methods
/ Outcome and process assessment (Health Care)
/ Patient Reported Outcome Measures
/ Patients
/ Tool use
/ Validity
