Summary
ADVERSE EFFECTS
This study shows that PEH have high levels of multimorbidity with each participant having an average of 8.5 LTCs, high levels of problem drug use, as well as complex health needs, and high treatment burden that affects physical, mental, and social wellbeing. They had extremely high scores on the PETS impact domains of physical and mental exhaustion because of self-management and role and social activity limitations, highlighting the major adverse effects of the work of self-management on functioning and wellbeing.