Treatment fatigue is common, and habit science can make your routine easier to keep

Key takeaways

• In studies of treatment burden, about 4 in 10 patients report a care workload that is hard to keep up over time¹.
• New habits take a while: in a University College London study, the median was 66 days, and one missed day did not knock people off course².
• Habit-based approaches, such as linking pills to breakfast, stood out in research reviews on taking medicines as planned³⁴.
• Simple “if-then” plans have been studied in 642 tests, and a 2025 review found them effective⁵.
• A regular review with your pharmacist, plus help from family and peers, can make a long routine lighter and more satisfying³⁶.

Doing every recommended self-care task for type 2 diabetes, plus related paperwork, would take about 143 minutes a day. That was the estimate for an adult with stable diabetes in a 2005 study in The Journal of Family Practice⁷. Exercise and healthy eating tasks took up most of that time⁷. That is more than two hours daily, on top of work, family and sleep.

No wonder long routines can wear people down. In 2003, the World Health Organization reported that adherence to long-term therapies averages only about 50 percent in developed countries⁸. Later researchers pointed out that this round number rests on two older studies from the 1960s and 1970s⁹. Real rates vary widely by condition and by how they are measured⁹. Still, the main lesson holds: keeping up a health plan for years takes steady effort.

The WHO also noted that patients are too often blamed when a treatment plan slips⁸. Researchers now see the problem in a more helpful way. They call it treatment burden, and they have built a care approach called minimally disruptive medicine around lightening it¹⁰. Habit science adds practical tools that make each daily step feel easier. Together, they offer an upbeat playbook for medicines, supplements, movement, food plans and appointments.

Treatment fatigue is a workload problem that researchers can measure

Researchers describe treatment burden as the “work” of being a patient and the effect of that work on quality of life¹¹. The work adds up quickly. It includes getting and renewing prescriptions, traveling to appointments and fitting treatments into daily routines¹².

One survey, the 15-question Treatment Burden Questionnaire, asks about taking medicines, lab tests, self-monitoring and doctor visits¹¹¹. It also covers organizing care, paperwork, diet and activity advice, and the social side of treatment¹¹. The English version, tested with 610 adults living with chronic conditions, added questions on out-of-pocket costs and on relationships with care providers¹¹. Two other surveys, called PETS and the MTBQ, measure the same idea in slightly different ways¹.

These tools show that feeling worn out is common. A 2022 progress report in Mayo Clinic Proceedings noted that about 4 in 10 patients report a level of treatment burden that is likely unsustainable¹. On the questionnaire’s 150-point scale, a score of 59 signals that kind of load¹.

Burden tends to run higher for people with more chronic conditions, people taking many medicines and younger adults¹. Living with a mental health condition can add to it as well¹. Money worries and “exhaustion associated with self-care” also go along with a heavier load¹².

The load and the follow-through move together. In the 610-person study, people with low medication adherence averaged 61.8 on the burden scale, compared with 37.7 for those with moderate or high adherence¹¹. A survey of 427 older Australians with diabetes adds a real-world picture. Of them, 44 percent took six or more prescription medicines every day, and about 3 in 4 reported time spent in waiting rooms¹³.

When the workload keeps outpacing a person’s capacity, researchers describe a cycle¹². Steps get missed, self-care starts to feel exhausting, and the plan may be stepped up, which adds even more work¹². Seeing the whole load at once is the first step toward easing it.

Minimally disruptive medicine shapes care around your life

In 2009, researchers Carl May, Frances Mair and Victor Montori made the case in the BMJ for “minimally disruptive medicine”¹⁰. They argued that the growing workload of chronic disease care can lead to missed treatments, wasted resources and poorer results¹⁰. Their answer was to fit treatment plans to the realities of each person’s everyday life¹⁰.

The approach weighs two things side by side: the workload a plan creates and a person’s capacity to carry it¹. Capacity includes your personal and financial resources, your home and work setting, and the people around you¹. When the workload outgrows capacity, the plan or the support around it needs to change¹.

On the workload side, one strategy is streamlining appointment schedules and prescription refills¹². Care teams can also look for chances to simplify parts of a plan when that matches what matters most to the patient¹. Those decisions belong to you and your clinicians together.

On the capacity side, the field has built a conversation tool called the ICAN Discussion Aid. It helps patients and clinicians talk openly about burden and capacity during a visit¹. In a pilot, visits using the aid averaged 31.6 minutes, compared with 34.5 minutes without it, so the conversation did not add time¹. Another program, Capacity Coaching, pairs patients with a coach who works with them and their care team to lighten the work and build up capacity¹. Early feedback from patients was positive¹.

Patients in this research have also asked for more patient-centered scheduling, less scattered care and connection with other patients for peer support¹. You can borrow the idea today. Before your next visit, write down everything your routine asks of you in a typical week. Then ask, “Which of these matters most for my goals, and can any of it be made simpler?”

A new habit takes about two months to settle in

In a study published in 2010, Phillippa Lally and colleagues at University College London followed 96 volunteers for 12 weeks². Each person picked one healthy eating, drinking or activity behavior to do daily in the same setting². Examples included eating a piece of fruit with lunch and running for 15 minutes before dinner². Each day, volunteers logged on and rated how automatic the behavior felt².

For the people whose data fit the researchers’ model well, the median time to reach near-peak automaticity was 66 days². The spread was wide, from 18 to 254 days². Exercise habits took longer, with a median of 91 days, compared with 65 days for eating habits and 59 for drinking habits². The authors noted that the study was not large enough to be sure about that difference.

Then came the most encouraging finding. Missing one opportunity “did not materially affect the habit formation process”². A slip is a normal part of building a habit.

A 2024 review in the journal Healthcare pulled together 20 studies with 2,601 participants¹⁴. Median times to form a habit ranged from 59 to 66 days, though individual times ran anywhere from 4 to 335 days¹⁴. Habits practiced in the morning, and habits people chose for themselves, tended to be stronger¹⁴. One of the habits studied was taking vitamins¹⁴.

In a 2012 article for family doctors, Gardner, Lally and Wardle advised telling patients to expect about 10 weeks¹⁵. They called the popular 21-day rule a myth¹⁵. They also noted that simple actions, like drinking water, became automatic faster than elaborate routines¹⁵.

For a long-term routine, this is good news. Give each new step two to three months of steady practice at the same point in your day. Expect bigger changes, like a new exercise plan, to take a little longer.

Anchor each step to something you already do

Habit researchers suggest tying a new action to a cue already in your day, such as “after breakfast”¹⁵. Another of their examples is “when I go on my lunch break”¹⁵. Many people call this habit stacking. Psychologists call a closely related tool an implementation intention, which is simply a plan written in an “if-then” format¹⁶. “If I sit down to breakfast, then I take my morning vitamins” is one example.

These plans have a strong track record. A 2006 analysis by psychologists Gollwitzer and Sheeran pooled 94 studies with more than 8,000 people¹⁶. It found a medium-to-large effect on reaching goals¹⁶. A 2025 update covering 642 tests found that if-then planning was effective for thinking, feeling and behavior outcomes alike⁵.

Research on medicine routines points the same way. In a 2017 review of 771 trials, Conn and Ruppar compared many kinds of support³. Habit-based and behavior-focused approaches had larger effects than ones aimed mainly at knowledge and beliefs³. A 2015 review led by Conn looked at 112 comparisons involving 34,272 people with high blood pressure⁴. The most promising parts included linking pill-taking to existing habits, pill boxes or special packaging, and checking blood pressure at home⁴. Programs that combined several parts and ran over many days did best⁴.

Here is how anchoring can look across a full routine.

Part of your routine	Anchor to pair it with	Sample if-then plan
Morning medicines and vitamins	Breakfast	If I sit down to breakfast, then I take my morning pills.
A healthy eating step	Lunch at home	After I have lunch at home, I eat a piece of fruit.
Movement	End of lunch	If I finish lunch, then I walk for 10 minutes.
Home health checks	Morning coffee	If the coffee is brewing, then I check and log my numbers.
Weekly pill organizer	One set evening	If it is Sunday after dinner, then I fill next week’s organizer.
Visits and refills	Paying monthly bills	If I pay the bills, then I check upcoming visits and refills.

Sources:²⁴¹⁵¹⁶

Make the supplement and medicine side of your day simpler

For many people, supplements are a valued part of a daily wellness routine, right alongside prescriptions. Every separate moment in your day is one more cue to build. A little streamlining makes the whole routine easier to carry.

Start by lining things up. Ask your pharmacist whether any doses could share a time of day. You can also ask whether refills can be set to the same date, a kind of streamlining that treatment burden researchers recommend¹². Making treatment easier to carry out is a core goal of minimally disruptive care¹. Any change to a prescription schedule should come from your pharmacist or prescriber, who can work it out together.

A weekly pill organizer is a simple helper with research behind it. Pill boxes and special packaging were among the most promising tools in the 2015 review⁴. Fill yours at the same time each week, so the refill becomes its own small habit.

Pair your supplements with a meal you never skip. Follow the label directions on timing, and if a product is meant to be taken with food, breakfast makes a natural anchor. Morning habits tended to be sturdier in the 2024 habit review¹⁴.

Combined formulas can also help. A multivitamin and mineral formula can cover several nutrients in one daily tablet, which means fewer bottles and one cue instead of many. That makes your morning simpler and your organizer easier to fill.

A few smart-use habits keep everything working well together. Choose products with a third-party quality seal, such as USP Verified, NSF Certified for Sport or ConsumerLab approved. Give any new addition a steady 8 to 12 weeks before you judge how it fits your routine. Keep one current list of everything you take, prescriptions and supplements together, and share it with your whole care team.

In the 771-trial review, the most effective programs were delivered face to face, by pharmacists, directly to patients³. That makes a “brown bag” visit worth booking once or twice a year. Bring every bottle you take to your pharmacist and go through them together. The library’s separate guides on supplement and medicine interactions and on reading Supplement Facts labels go deeper.

Go easy on yourself after a missed day

A 2003 summary of the WHO report in the Pan American Journal of Public Health put it plainly: “Patients need to be supported, not blamed”⁶. That support can start with the way you talk to yourself.

The habit research backs a gentle approach. In the University College London study, one missed opportunity did not derail habit formation². In their article for doctors, Gardner and colleagues noted that progress picked up again soon after a single miss¹⁵. A missed day is a pause, and the next cue is a fresh start.

Plan your restart before you need it. Write a backup if-then plan, such as “If I miss my morning walk, then I walk after dinner.” For a missed medicine dose, check the label or ask your pharmacist what to do, since the answer differs from one medicine to the next.

How you feel about a habit matters too. The 2024 review found that people’s feelings about a habit, and whether they chose it themselves, both shaped how strong it became¹⁴. So pick movement you like, and build your food plan around meals you enjoy. Having a hand in designing your routine helps too.

Keep the first steps small. Gardner and colleagues suggest small, manageable changes, like walking one or two extra bus stops rather than the whole route¹⁵. Small wins are easier to repeat, and repetition is what turns a step into a habit.

Bring your people and your care team into the plan

You do not have to carry a long routine alone. The same 2003 summary called the family, the community and patients’ organizations “key to improving adherence”⁶. It added that support from peers and other community members can help people stay with their therapy while saving clinicians’ time⁶.

Research on patient capacity says the same thing in a different way. A person’s social network can make the work of treatment easier to carry¹. Social prescribing programs, which connect patients with sources of support outside the clinic, are one way health systems are building on that idea¹.

At home, this can be simple. A partner or friend can fill the weekly organizer with you on Sunday evenings. A neighbor can become your walking buddy. A patient group for your condition can trade tips that no handout covers.

Your care team is part of your support network too. Ask for a full routine review every few months, or whenever something changes. Bring your list of weekly tasks and the two that feel hardest. Ask whether appointments can be grouped, whether refills can be lined up, and which steps matter most for your goals¹¹².

A checklist for an easier routine

• List every task your routine asks of you in a typical week, from medicines and supplements to movement, meals, home checks and appointments.

• Circle the two tasks that feel hardest right now, and bring the list to your next visit.

• Ask your pharmacist whether doses can share fewer times of day and whether refills can be lined up.

• Book a pharmacist review at least once a year, and bring every bottle, prescriptions and supplements alike.

• Pair each daily step with an anchor you already do, such as breakfast or brushing your teeth.

• Write one if-then plan for each anchor, and post it where you will see it.

• Fill a weekly pill organizer at the same time each week.

• Pick movement you enjoy, and start with a small, easy amount.

• Choose supplements with a third-party quality seal, and keep your full list current.

• Write a restart plan for missed days, and ask your pharmacist what to do if you miss a medicine dose.

• Tell one person about your plan, or join a peer group.

• Give each new habit two to three months, and review the whole routine every few months.

The bottom line

A long-term health routine is real work, and feeling tired of it is common. Researchers now have names and measuring tools for that load. A growing care movement aims to shape plans around your life instead of the other way around¹¹⁰.

Habit science fills in the rest. Tie each step to something you already do, write simple if-then plans, and give new habits about two months to settle in²¹⁴¹⁶. Streamline where you can, with a weekly organizer, a combined multivitamin and a regular pharmacist review.

Most of all, be a good teammate to yourself. A missed day is part of the process, and the people around you can help carry the load. A routine that fits your life is one you can keep, and feel good about, for years.

Sources

1. Boehmer KR, Gallacher KI, Lippiett KA, Mair FS, May CR, Montori VM. Minimally disruptive medicine: progress 10 years later. Mayo Clinic Proceedings. 2022. eprints.gla.ac.uk

2. Lally P, van Jaarsveld CHM, Potts HWW, Wardle J. How are habits formed: modelling habit formation in the real world. European Journal of Social Psychology. 2010. core.ac.uk

3. Conn VS, Ruppar TM. Medication adherence outcomes of 771 intervention trials: systematic review and meta-analysis. Preventive Medicine. 2017. pubmed.ncbi.nlm.nih.gov

4. Conn VS, Ruppar TM, Chase JD, Enriquez M, Cooper PS. Interventions to improve medication adherence in hypertensive patients: systematic review and meta-analysis. Current Hypertension Reports. 2015. cbsm.com

5. Sheeran P, Listrom O, Gollwitzer PM. The when and how of planning: meta-analysis of the scope and components of implementation intentions in 642 tests. European Review of Social Psychology. 2025. kops.uni-konstanz.de

6. Pan American Journal of Public Health. Poor adherence to long-term treatment of chronic diseases is a worldwide problem. Revista Panamericana de Salud Pública. 2003. scielosp.org

7. Russell LB, Suh DC, Safford MM. Time requirements for diabetes self-management: too much for many? The Journal of Family Practice. 2005. mdedge.com

8. World Health Organization. Failure to take prescribed medicine for chronic diseases is a massive, world-wide problem. WHO News. 2003. who.int

9. Mathes T, Pieper D, Antoine SL, Eikermann M. 50% adherence of patients suffering chronic conditions: where is the evidence? GMS German Medical Science. 2012. books.publisso.de

10. May C, Mair F, Montori VM. We need minimally disruptive medicine. BMJ. 2009. eprints.gla.ac.uk

11. Tran VT, Harrington M, Montori VM, Barnes C, Wicks P, Ravaud P. Adaptation and validation of the Treatment Burden Questionnaire (TBQ) in English using an internet platform. BMC Medicine. 2014. pmc.ncbi.nlm.nih.gov

12. Spencer-Bonilla G, Quiñones AR, Montori VM, International Minimally Disruptive Medicine Workgroup. Assessing the burden of treatment. Journal of General Internal Medicine. 2017. link.springer.com

13. Yen LE, McRae IS, Jowsey T, Bagheri N. Time spent on health related activity by older Australians with diabetes. Journal of Diabetes and Metabolic Disorders. 2013. link.springer.com

14. Singh B, Murphy A, Maher C, Smith AE. Time to form a habit: a systematic review and meta-analysis of health behaviour habit formation and its determinants. Healthcare (Basel). 2024. pubmed.ncbi.nlm.nih.gov

15. Gardner B, Lally P, Wardle J. Making health habitual: the psychology of “habit-formation” and general practice. British Journal of General Practice. 2012. pmc.ncbi.nlm.nih.gov

16. Wieber F, Thürmer JL, Gollwitzer PM. Promoting the translation of intentions into action by implementation intentions: behavioral effects and physiological correlates. Frontiers in Human Neuroscience. 2015. frontiersin.org

This article is for general education and is not medical advice. Talk with your healthcare professional about your own health, especially before starting a new supplement if you are pregnant, nursing, taking medicine, or managing a health condition. Statements about dietary supplements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease. Reviewed October 2026.