Therapeutic inertia

Abstract

Summary Therapeutic inertia, sometimes referred to as clinical inertia, has been defined as failure to initiate or intensify therapy when therapeutic goals are not reached. Lack of initiation or intensification of treatment according to clinical guidelines has been linked to suboptimal control of a range of chronic conditions. Clinician factors contributing to therapeutic inertia include knowledge gaps; discomfort with uncertainty about the diagnosis, therapeutic target, or evidence; concerns about the safety of treatment intensification; and time constraints. Patient characteristics that may be associated with therapeutic inertia include male sex, older age, lower life expectancy, multiple comorbidities and clinical parameters that are close to target. There may be reasons other than therapeutic inertia that explain apparent undertreatment. Apparent inertia in prescribing may be accompanied by appropriate actions, such as provision of lifestyle advice or interventions to promote adherence to existing medication. Some patients choose not to intensify treatment. Interventions to reduce therapeutic inertia include access to evidence-based treatment guidelines and point-of-care tools, preferably integrated with clinical record systems; clinician education including educational visits; reminders; clinical audits with feedback and reflection on practice; shared decision-making; prompting by patients; and ambulatory or home monitoring (e.g. ambulatory blood pressure monitoring).

Assessing LDL Cholesterol Management and Statin Use in Diabetic Patients: Disparities and Outcomes in a Vietnamese Tertiary Hospital Setting

“…role16 . The challenges of high patient volumes and time constraints, particularly prevalent in Vietnamese tertiary hospitals, exacerbate this issue16 .…”

“…role16 . The challenges of high patient volumes and time constraints, particularly prevalent in Vietnamese tertiary hospitals, exacerbate this issue16 . Addressing clinical inertia necessitates a comprehensive approach that includes education for both clinicians and patients, team-based care, and population health management strategies17 .…”