Interventions to Reduce Clinical Inertia in Cardiac Risk Factor Management in Renal Transplant Recipients

Abstract

Cardiovascular disease (CVD) is the leading cause of death in renal transplant recipients (RTRs). Clinical inertia (CI) is defined as “recognition of the problem, but failure to act.” The effect of educational interventions in minimizing CI in CVD risk factor management was assessed. Educational sessions were conducted among 201 RTRs to inform them about their goals for blood pressure (BP), low‐density lipoprotein cholesterol (LDL‐C) and glycated hemoglobin (HbA1c). Physicians were reminded about treatment goals using checklists. Pre‐intervention and post‐intervention CI was measured as “no action” or “appropriate action” by the physicians. Post‐intervention percentage of RTRs with “no clinical action” for BP, LDL‐C, and HbA1c control decreased from 10.8% to 3.8% (P=.02), 28.2% to 11.1% (P=.008), and 10.3% to 4.5% (P=.05), respectively, while those with “appropriate action” increased from 66.2% to 83.3% (P<.001), 68.7% to 79.4% (P=.008), and 85.1% to 93.2% (P=.03), respectively. Educational interventions and patient participation were shown to reduce CI.

Overcoming Therapeutic Inertia in Multiple Sclerosis Care: A Pilot Randomized Trial Applying the Traffic Light System in Medical Education

“…The current evidence suggests that medical decisions leading to TI are likely related to knowledge-to-action gaps ( 23 , 24 ). We developed a simulation-based educational intervention aimed at facilitating the integration of knowledge and overcoming knowledge-to-action gaps in MS care ( 25 ).…”