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Background: Physicians and other healthcare professionals involved in the care of patients with multimorbidity should consider the problems these patients experience in managing their own conditions. However, treatment burden from the patient's perspective has been poorly explored, even though this might hamper treatment adherence., Objective: The present study examined the experiences of patients with multimorbidity in primary care in the Netherlands and Belgium using semi-structured interviews, with special attention to the daily life domains of treatment burden., Design: Individual interviews gathering qualitative data to explore the treatment burden experienced by patients with multimorbidity in primary care. Twenty-two patients agreed to participate: seven men and fifteen women. The recorded interviews were transcribed verbatim and evaluated using thematic content analysis., Results: The patients reported numerous aspects of treatment burden they experienced in various domains of their daily lives. These topics were categorized into four daily life domains of burden: organization of care, medication, patient's role, and impact on daily life (including the involvement of caregivers)., Conclusions: The findings indicate that primary care patients with multimorbidity report treatment burden in several domains of their daily lives, not restricted to medical issues, such as side effects of medication. Some issues, such as those related to organization of care, seem easily modifiable. Further research is required focusing on special factors of treatment burden as experienced by patients with multimorbidity, and the implications for treatment adherence, especially in European settings, as little information is currently available., Competing Interests: The authors declare no conflicts of interest.

This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

Community health psychology provides a framework for local citizens themselves to systematically affect change in health and social inequalities, particularly through Participatory Action Research (PAR). The Cambodian NGO SiRCHESI launched a 24-month Hotel Apprenticeship Program (HAP) in 2006 to provide literacy, English, social skills, health education, hotel skills-training, work experience and a living wage to women formerly selling beer in restaurants; there they had faced workplace risks including HIV/AIDS, alcohol overuse, violence and sexual coercion. Quantitative and qualitative analyses indicate changes in health-related knowledge, behaviour, self-image and empowerment, as HAP trainees were monitored and evaluated within their new career trajectories.