{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:51:17Z","timestamp":1791827477085,"version":"4.3.4"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000589","name":"Chief Scientist Office","doi-asserted-by":"publisher","award":["CAF\/23\/03"],"award-info":[{"award-number":["CAF\/23\/03"]}],"id":[{"id":"10.13039\/501100000589","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>People with kidney disease who need to transition onto kidney replacement therapy (KRT) face a life-changing diagnosis. This process involves complex decisions about treatment and a high volume of healthcare work. Little work has been done looking at KRT transition through the lens of treatment burden. This study aims to explore how treatment burden evolves during KRT transition in a population recruited from a large nephrology and kidney transplant unit in Glasgow, Scotland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods and findings<\/jats:title>\n                    <jats:p>Serial in-depth qualitative interviews were conducted with 30 participants across up to three time points, generating 76 interviews. We used a framework analysis informed by Normalisation Process Theory (NPT), Theory of Patient Capacity (TPC) and Burden of Treatment Theory (BoTT) to explore the interaction between workload, capacity, and the system. Five main themes affecting treatment burden arose: engaging personal and social resources to navigate KRT transition, being able to meet the challenges, preparing to enact the healthcare workload, undertaking KRT transition related workload, and the evolution of burden over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Transitioning onto KRT is a process that entails a high volume of healthcare workload and significant treatment burden. Experiences of treatment burden are influenced by the nature of the work required; the patient\u2019s capacity including physical, psychological, financial and cognitive factors; the capacity of their social network; and the functioning of the healthcare system. Particular focus should be placed on understanding the impact of the healthcare system on experiences of burden, as it represents a potentially modifiable driver of treatment burden that clinicians and healthcare policy-makers can directly influence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0360290","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:28:07Z","timestamp":1791826087000},"page":"e0360290","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploration of treatment burden during transition onto kidney replacement therapy: A longitudinal qualitative study"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3352-6917","authenticated-orcid":true,"given":"Catrin","family":"Jones","sequence":"first","affiliation":[{"name":"University of Glasgow","place":["Glasgow, Scotland"],"department":["School of Health and Wellbeing"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Edgar","sequence":"additional","affiliation":[{"name":"University of Glasgow","place":["Glasgow, Scotland"],"department":["School of Cardiovascular and Metabolic Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Stevenson","sequence":"additional","affiliation":[{"name":"NHS Greater Glasgow and Clyde","place":["Glasgow, Scotland"],"department":["Department of Renal Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhautesh","family":"Jani","sequence":"additional","affiliation":[{"name":"University of Glasgow","place":["Glasgow, Scotland"],"department":["School of Health and Wellbeing"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3387-2123","authenticated-orcid":true,"given":"Patrick","family":"Mark","sequence":"additional","affiliation":[{"name":"University of Glasgow","place":["Glasgow, Scotland"],"department":["School of Cardiovascular and Metabolic Health"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Gallacher","sequence":"additional","affiliation":[{"name":"University of Glasgow","place":["Glasgow, Scotland"],"department":["School of Health and Wellbeing"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"pone.0360290.ref001","article-title":"Thinking about the burden of treatment","volume":"349","author":"FS Mair","year":"2014","journal-title":"BMJ"},{"key":"pone.0360290.ref002","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/1741-7015-8-63","article-title":"Normalisation process theory: A framework for developing, evaluating and implementing complex interventions","volume":"8","author":"E Murray","year":"2010","journal-title":"BMC Med"},{"issue":"1","key":"pone.0360290.ref003","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1186\/s12875-016-0525-9","article-title":"Patient capacity and constraints in the experience of chronic disease: A qualitative systematic review and thematic synthesis","volume":"17","author":"KR Boehmer","year":"2016","journal-title":"BMC Fam Pract"},{"issue":"1","key":"pone.0360290.ref004","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1186\/1472-6963-14-281","article-title":"Rethinking the patient: using burden of treatment theory to understand the changing dynamics of illness","volume":"14","author":"CR May","year":"2014","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0360290.ref005","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s12916-025-03904-7","article-title":"Exploration of treatment burden through examination of workload and patient capacity during transition onto kidney replacement therapy: A systematic review of qualitative research","volume":"23","author":"C Jones","year":"2025","journal-title":"BMC Med"},{"issue":"13","key":"pone.0360290.ref006","doi-asserted-by":"crossref","first-page":"1753","DOI":"10.1177\/1049732315617444","article-title":"Sample size in qualitative interview studies: Guided by information power","volume":"26","author":"K Malterud","year":"2016","journal-title":"Qual Health Res"},{"issue":"2","key":"pone.0360290.ref007","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1080\/2159676X.2019.1704846","article-title":"To saturate or not to saturate? 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