What does this research mean for the field?

The Short Treatment Burden Questionnaire (STBQ) is a novel patient-reported outcome measure that effectively identifies treatment burden in adults living with multimorbidity. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To create and refine the Short Treatment Burden Questionnaire (STBQ) to identify treatment burden in individuals with multimorbidity.

February 28, 2026Open Access

Development of the Short Treatment Burden Questionnaire (STBQ) including a Global Treatment Burden Question (GTBQ): Cognitive interviews with adults living with multimorbidity

Key Result

The Short Treatment Burden Questionnaire (STBQ) was developed with good face validity and usability to identify treatment burden in adults with multimorbidity for clinical use.

Key Points

To create and refine the Short Treatment Burden Questionnaire (STBQ) to identify treatment burden in individuals with multimorbidity.
Developed the STBQ based on the Multimorbidity Treatment Burden Questionnaire (MTBQ) and a global measure.
Conducted three rounds of cognitive interviews with adults aged 18-65.
Analyzed feedback to improve understandability, layout, and wording of the questionnaire.
Identified layout, instruction, and response option issues in initial prototypes.
Reduced issues with each round of interviews, enhancing understanding of the questionnaire.
Participants expressed how the STBQ could help in clinical practice by encouraging discussion of treatment concerns.

Structured PICO

Population

Adults aged 18–65 living with multimorbidity, recruited from English general practices (n=15)

Intervention

Development and cognitive interviewing of the Short Treatment Burden Questionnaire (STBQ) including a Global Treatment Burden Question (GTBQ)

Outcome

Understandability, face validity, and patient views on using the STBQ in clinical practicepatient reported

The Short Treatment Burden Questionnaire (STBQ) was developed and demonstrated face validity for identifying patients experiencing high treatment burden in clinical practice.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background A short patient reported outcome measure (PROM) could help identify people experiencing high treatment burden. Objectives To develop the Short Treatment Burden Questionnaire (STBQ), a novel PROM comprising a Global Treatment Burden Question (GTBQ) and items to identify areas of difficulty; improve its understandability and face validity; and explore patient views on using it in clinical practice. Methods Prototype development drew on the validated Multimorbidity Treatment Burden Questionnaire (MTBQ) and a single-item global measure. Adults, aged 18–65, living with multimorbidity were recruited from English general practices. Three rounds of cognitive interviews, with think-aloud and prompts, were conducted (July–October 2023). After each round, data were analysed, suggested changes and uncertainties discussed and modifications made. Public contributors were involved throughout. Results Participants (n = 15) were predominantly female (67%) and White British (87%). Issues were identified with the layout, instructions, and order and wording of response options, with some aspects interpreted in unintended ways. The number of issues and consequent changes reduced with each round of interviews. Participants highlighted potential benefits of using the STBQ in clinical practice, including encouraging patients to mention things they may not otherwise bring up. They suggested the STBQ could inform both individual patient care and practice-level service improvement. Conclusions Robust qualitative methods were used to develop a novel PROM for use in clinical practice and research. The STBQ demonstrated face validity and was relatively easy to use. Further work has been undertaken to validate the GTBQ. Guidance will outline how the STBQ could support patient care.