Persons With Diabetes and General/Family Practitioner Perspectives Related to Therapeutic Inertia in Type 2 Diabetes Mellitus Using Qualitative Focus Groups and the Theoretical Domains Framework: Results From the MOTION Study

Wrzal, Paulina K.; Mohseni, Amir A.; Fournier, Carl; Goldenberg, Ronald; Hollahan, Debbie; Jin, Susie; Pedersen, Sue D.; Vallis, Michael; Bunko, Andrean; Myageri, Varun; Kukaswadia, Atif; Neish, Calum S.; Ivers, Noah

doi:10.1016/j.jcjd.2021.08.004

Cited by 3 publications

(6 citation statements)

References 36 publications

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“…This tool supports HCP behavioural change and helps to overcome therapeutic inertia by targeting physical opportunities (relating to time, resources, location, etc. ), social opportunities (opportunity afforded by interpersonal influences) and reflective motivation (involving plans and evaluations) [ 40 ].…”

Section: What Needs To Be Done?mentioning

confidence: 99%

“…Performance improvement is dependent on a variety of factors, not least of which is the skill and knowledge of the HCP. Being up to date with the latest guidance/evidence and using such guidance in a manner that promotes best practice is imperative [ 39 , 40 ]. Developing pathways and protocols to suit local population needs could ensure equity of care and reduce variation [ 13 , 41 ].…”

Section: What Needs To Be Done?mentioning

confidence: 99%

“…Inertia has long been a detrimental factor in the management of long-term conditions; this can be both HCP- and patient-related [ 39 , 40 ]. To achieve the best outcomes for patients, HCPs need to be aware of the latest developments/guidelines and be able to implement them effectively.…”

Section: What Needs To Be Done?mentioning

confidence: 99%

“…Equally, patients need to be given as much information as possible, taking into consideration their health and digital literacy, to allow them to understand and take control of their condition. A well-motivated patient is likely to be engaged in shared decision-making, have improved adherence, and therefore see improvements in their own health and outcomes [ 39 , 40 ].…”

Section: What Needs To Be Done?mentioning

confidence: 99%

“…HCPs must also acquire and practice the art of empowering and motivating patients towards a healthier lifestyle [ 13 , 39 ]. Devoting time to the patient and demonstrating empathy is essential to be able to build a productive patient/physician relationship that will provide benefit in the long term, such as regarding medication adherence [ 39 , 40 ]. In short, engaging patients with shared decision-making is important to improve patient outcomes [ 13 , 40 ].…”

Section: What Needs To Be Done?mentioning

confidence: 99%

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Guardians For Health: A Practical Approach to Improving Quality of Life and Longevity in People with Type 2 Diabetes

Kanumilli¹,

Butler

Makrilakis

et al. 2023

Diabetes Ther

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Type 2 diabetes is one of the fastest-growing health emergencies of the twenty-first century, in part due to its association with cardiovascular and renal disease. Successful implementation of evidence-based guidelines for the management of patients with diabetes and pre-diabetes has been shown to improve patient outcomes by controlling risk factors for cardiovascular and renal disease. Recommendations include the early introduction of lifestyle adjustments, supported by pharmacological tools. Despite the availability of regularly updated, evidence-based guidelines, guideline implementation in clinical practice is low. As a result, people living with type 2 diabetes are not consistently receiving ideal clinical care. Improving guideline adherence has the potential to improve quality of life and longevity in patients with type 2 diabetes. This article introduces Guardians For Health , a global initiative that aims to improve guideline adherence by simplifying patient management and encouraging patient participation in the implementation of guidelines for type 2 diabetes. Guardians For Health is supported by a global community of implementers, with tools to support decision-making and quality assurance. Through achieving better guideline adherence, Guardians For Health hopes to achieve its vision to “stop early mortality by reducing cardiovascular and kidney complications in people with type 2 diabetes”.

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Section: What Needs To Be Done?mentioning

confidence: 99%

Section: What Needs To Be Done?mentioning

confidence: 99%

Section: What Needs To Be Done?mentioning

confidence: 99%

Section: What Needs To Be Done?mentioning

confidence: 99%

Section: What Needs To Be Done?mentioning

confidence: 99%

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Guardians For Health: A Practical Approach to Improving Quality of Life and Longevity in People with Type 2 Diabetes

Kanumilli¹,

Butler

Makrilakis

et al. 2023

Diabetes Ther

Self Cite

View full text Add to dashboard Cite

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Therapeutic Inertia in the Management of Type 2 Diabetes: A Narrative Review

Rodriguez,

San Martin,

Pantalone

2024

Diabetes Ther

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Adequate glycemic control is key to prevent morbi-mortality from type 2 diabetes (T2D). Despite the increasing availability of novel, effective, and safe medications for the treatment of T2D, and periodically updated guidelines on its management, the overall rate of glycemic goal attainment remains low (around 50%) and has not improved in the past decade. Therapeutic inertia (TI), defined as the failure to advance or de-intensify medical therapy when appropriate to do so, has been identified as a central contributor to the lack of progress in the rates of HbA1c goal attainment. The time to treatment intensification in patients not meeting glycemic goals has been estimated to be between 1 and 7 years from the time HbA1c exceeded 7%, and often, even when an intervention is carried out, it proves insufficient to achieve glycemic goals, which led to the concept of intensification inertia. Therefore, finding strategies to overcome all forms of TI in the management of T2D is a fundamental initiative, likely to have an enormous impact in health outcomes for people with T2D. There are several factors that have been described in the literature leading to TI, including clinician-related, patient-related, and healthcare system-related factors, which are discussed in this review. Likewise, several interventions addressing TI had been tested, most of them proving limited efficacy. Within the most effective interventions, there appear to be two common factors. First, they involve a team-based effort, including nurses, pharmacists, and diabetes educators. Second, they were built upon a framework based on results of qualitative studies conducted in the same context where they were later implemented, as will be discussed in this article. Given the complex nature of TI, it is crucial to use a research method that allows for an in-depth understanding of the phenomenon. Most of the literature on TI is focused on quantitatively describing its consequences; unfortunately, however, not many study groups have undertaken qualitative studies to deeply investigate the drivers of TI in their diverse contexts. This is particularly true in the United States, where there is an abundance of publications exploring the effects of different strategies to overcome TI in type 2 diabetes, but a severe shortage of qualitative studies aiming to truly understand the phenomenon.

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A Cross-sectional Survey to Assess Reasons for Therapeutic Inertia in People With Type 2 Diabetes Mellitus and Preferred Strategies to Overcome It From the Perspectives of Persons With Diabetes and General/Family Practitioners: Results From the MOTION Study

Wrzal¹,

Mohseni²,

Fournier³

et al. 2022

Canadian Journal of Diabetes

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Persons With Diabetes and General/Family Practitioner Perspectives Related to Therapeutic Inertia in Type 2 Diabetes Mellitus Using Qualitative Focus Groups and the Theoretical Domains Framework: Results From the MOTION Study

Cited by 3 publications

References 36 publications

Guardians For Health: A Practical Approach to Improving Quality of Life and Longevity in People with Type 2 Diabetes

Guardians For Health: A Practical Approach to Improving Quality of Life and Longevity in People with Type 2 Diabetes

Therapeutic Inertia in the Management of Type 2 Diabetes: A Narrative Review

A Cross-sectional Survey to Assess Reasons for Therapeutic Inertia in People With Type 2 Diabetes Mellitus and Preferred Strategies to Overcome It From the Perspectives of Persons With Diabetes and General/Family Practitioners: Results From the MOTION Study

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