Implications for research and practice
An assessment of treatment burden is an important person-centred outcome to help compare the effectiveness of interventions in PEH, and merits inclusion in future trials as an outcome measure. Understanding more about the treatment burden of PEH can help shape how to better tailor healthcare interventions to this socially marginalised, multimorbid group. Other than PHOENIx (which is under evaluation through the pilot RCT described above), there are currently no specific interventions in the UK, to the authors’ knowledge, to reduce the treatment burden workload of PEH. Tailored, intersecting outreach services, such as the PHOENIx intervention, may bridge a gap, while PEH are navigating poor health and high treatment burden where mainstream services may not meet their needs.In conclusion, this study provides, to the authors’ knowledge, the first ever data on treatment burden in PEH. Results indicate that there is a profound negative impact on the overall functioning and wellbeing of this population because of their need to self-manage multimorbidity. This adds to barriers in patients accessing or participating in their health and self-care, and this study provides insights about why tailored input is needed, and what aspects can be targeted through multifaceted support interventions.The authors thank the PHOENIx team and participants in the trial.