Disparities in treatment burden in Peru among people with multiple long-term conditions by geography and healthcare facility: A cross-sectional study
People with multiple long-term conditions (MLTC) in low-resource settings face high treatment burdens, influenced by healthcare access and quality disparities. The study aimed to compare the treatment burden among patients with MLTC across geographical locations and healthcare providers in Peru. We...
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| Lenguaje: | inglés |
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2026
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| author | Silvana Pérez-León Daniel Mendoza‐Quispe María Sofía Cuba-Fuentes Juan Carlos Bazo‐Alvarez María Amalia Pesantes Andrea Gaspar Joseph Raymond Zunt Víctor M. Montori Jose A. Castillo Eduardo Carcausto Nelson Diaz Keveen Steve Salirrosas Flores Pilar Cornejo J. Jaime Miranda |
| author_browse | Andrea Gaspar Daniel Mendoza‐Quispe Eduardo Carcausto J. Jaime Miranda Jose A. Castillo Joseph Raymond Zunt Juan Carlos Bazo‐Alvarez Keveen Steve Salirrosas Flores María Amalia Pesantes María Sofía Cuba-Fuentes Nelson Diaz Pilar Cornejo Silvana Pérez-León Víctor M. Montori |
| author_facet | Silvana Pérez-León Daniel Mendoza‐Quispe María Sofía Cuba-Fuentes Juan Carlos Bazo‐Alvarez María Amalia Pesantes Andrea Gaspar Joseph Raymond Zunt Víctor M. Montori Jose A. Castillo Eduardo Carcausto Nelson Diaz Keveen Steve Salirrosas Flores Pilar Cornejo J. Jaime Miranda |
| author_sort | Silvana Pérez-León |
| collection | Producción científica |
| description | People with multiple long-term conditions (MLTC) in low-resource settings face high treatment burdens, influenced by healthcare access and quality disparities. The study aimed to compare the treatment burden among patients with MLTC across geographical locations and healthcare providers in Peru. We conducted a cross-sectional study conducted between June-October 2023 among outpatients aged ≥40 years with type 2 diabetes and ≥1 additional chronic condition, recruited from public and private healthcare facilities in urban Lima and semi-urban Tumbes, Peru. Treatment burden was assessed using the Multimorbidity Treatment Burden Questionnaire (MTBQ). Differences in median MTBQ scores by setting and healthcare provider were analyzed using regression models adjusting for capacity- and workload-related variables. Among 555 participants (55% female, mean age 62.4 ± 10.5 years), median MTBQ score was 27.1 (IQR 14.6-41.7). After adjustment, patients in semi-urban Tumbes had higher treatment burden than those in urban Lima (adjusted median difference 6.1 points; 95% CI 2.9 to 9.3), while patients receiving care in private facilities had lower treatment burden than those in public settings (-6.6 points; 95% CI -9.3 to -3.9). These findings highlight substantial inequalities in treatment burden by place and provider type, with implications for efforts to improve care delivery and reduce disparities for people living with MLTC. |
| format | Article |
| id | openalex:W7214742996 |
| institution | UPeU |
| language | English |
| publishDate | 2026 |
| publishDateRange | 2026 |
| publishDateSort | 2026 |
| record_format | dspace |
| spelling | openalex:W7214742996Disparities in treatment burden in Peru among people with multiple long-term conditions by geography and healthcare facility: A cross-sectional studySilvana Pérez-LeónDaniel Mendoza‐QuispeMaría Sofía Cuba-FuentesJuan Carlos Bazo‐AlvarezMaría Amalia PesantesAndrea GasparJoseph Raymond ZuntVíctor M. MontoriJose A. CastilloEduardo CarcaustoNelson DiazKeveen Steve Salirrosas FloresPilar CornejoJ. Jaime Mirandamultimorbiditytreatment burdentype 2 diabeteschronic diseasehealth care disparitiesurban-rural differenceshealth care accessquality of carePeruLimaTumbesChronic Disease Management StrategiesPharmaceutical Practices and Patient OutcomesDiabetes Management and EducationPeople with multiple long-term conditions (MLTC) in low-resource settings face high treatment burdens, influenced by healthcare access and quality disparities. The study aimed to compare the treatment burden among patients with MLTC across geographical locations and healthcare providers in Peru. We conducted a cross-sectional study conducted between June-October 2023 among outpatients aged ≥40 years with type 2 diabetes and ≥1 additional chronic condition, recruited from public and private healthcare facilities in urban Lima and semi-urban Tumbes, Peru. Treatment burden was assessed using the Multimorbidity Treatment Burden Questionnaire (MTBQ). Differences in median MTBQ scores by setting and healthcare provider were analyzed using regression models adjusting for capacity- and workload-related variables. Among 555 participants (55% female, mean age 62.4 ± 10.5 years), median MTBQ score was 27.1 (IQR 14.6-41.7). After adjustment, patients in semi-urban Tumbes had higher treatment burden than those in urban Lima (adjusted median difference 6.1 points; 95% CI 2.9 to 9.3), while patients receiving care in private facilities had lower treatment burden than those in public settings (-6.6 points; 95% CI -9.3 to -3.9). These findings highlight substantial inequalities in treatment burden by place and provider type, with implications for efforts to improve care delivery and reduce disparities for people living with MLTC.Articlehttps://doi.org/10.1371/journal.pgph.0007355https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0007355&type=printableW7214742996enPLOS Global Public Health2767-33752026-09-29 |
| spellingShingle | multimorbidity treatment burden type 2 diabetes chronic disease health care disparities urban-rural differences health care access quality of care Peru Lima Tumbes Chronic Disease Management Strategies Pharmaceutical Practices and Patient Outcomes Diabetes Management and Education Silvana Pérez-León Daniel Mendoza‐Quispe María Sofía Cuba-Fuentes Juan Carlos Bazo‐Alvarez María Amalia Pesantes Andrea Gaspar Joseph Raymond Zunt Víctor M. Montori Jose A. Castillo Eduardo Carcausto Nelson Diaz Keveen Steve Salirrosas Flores Pilar Cornejo J. Jaime Miranda Disparities in treatment burden in Peru among people with multiple long-term conditions by geography and healthcare facility: A cross-sectional study |
| title | Disparities in treatment burden in Peru among people with multiple long-term conditions by geography and healthcare facility: A cross-sectional study |
| title_full | Disparities in treatment burden in Peru among people with multiple long-term conditions by geography and healthcare facility: A cross-sectional study |
| title_fullStr | Disparities in treatment burden in Peru among people with multiple long-term conditions by geography and healthcare facility: A cross-sectional study |
| title_full_unstemmed | Disparities in treatment burden in Peru among people with multiple long-term conditions by geography and healthcare facility: A cross-sectional study |
| title_short | Disparities in treatment burden in Peru among people with multiple long-term conditions by geography and healthcare facility: A cross-sectional study |
| title_sort | disparities in treatment burden in peru among people with multiple long term conditions by geography and healthcare facility a cross sectional study |
| topic | multimorbidity treatment burden type 2 diabetes chronic disease health care disparities urban-rural differences health care access quality of care Peru Lima Tumbes Chronic Disease Management Strategies Pharmaceutical Practices and Patient Outcomes Diabetes Management and Education |
| topic_facet | multimorbidity treatment burden type 2 diabetes chronic disease health care disparities urban-rural differences health care access quality of care Peru Lima Tumbes Chronic Disease Management Strategies Pharmaceutical Practices and Patient Outcomes Diabetes Management and Education |
| url | https://doi.org/10.1371/journal.pgph.0007355 https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0007355&type=printable |
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