Understanding Clinical Inertia in DiabetesFunding None.
Received: 10 May 2019
Accepted: 18 May 2019
29 July 2019 (online)
Clinical inertia is common in the management of asymptomatic chronic disease such as diabetes, hypertension, and dyslipidemia. In case of diabetes, it exists in all stages of management of diabetes. It can be at population level or at patient level. In addition to assessment of glycemic control with blood glucose and hemoglobin A1C (HbA1C) monitoring, emerging concepts such as “glycemic variability” and “time in range” are increasingly used. Inability to reduce “glycemic variability” and attain “time in range” targets also contributes to clinical inertia.
- 1 Phillips LS, Branch WT, Cook CB. et al. Clinical inertia. Ann Intern Med 2001; 135 (09) 825-834
- 2 National Institute of Clinical Studies. Evidence-Practice Gaps Report. Vol. 1. Melbourne, Australia: NICS; 2003
- 3 Byrnes PD. Why haven’t I changed that? Therapeutic inertia in general practice. Aust Fam Physician 2011; 40 (1-2) 24-28
- 4 Okonofua EC, Simpson KN, Jesri A, Rehman SU, Durkalski VL, Egan BM. Therapeutic inertia is an impediment to achieving the Healthy People 2010 blood pressure control goals. Hypertension 2006; 47 (03) 345-351
- 5 Gil-Guillén V, Orozco-Beltrán D, Pérez RP. et al. Clinical inertia in diagnosis and treatment of hypertension in primary care: quantification and associated factors. Blood Press 2010; 19 (01) 3-10
- 6 Reach G. Patient non-adherence and healthcare-provider inertia are clinical myopia. Diabetes Metab 2008; 34 (4 Pt 1) 382-385
- 7 Rodrigo C, Amarasuriya M, Wickramasinghe S, Constantine GR. Therapeutic momentum: a concept opposite to therapeutic inertia. Int J Clin Pract 2013; 67 (01) 97-98
- 8 Giugliano D, Maiorino MI, Bellastella G, Esposito K. Clinical inertia, reverse clinical inertia, and medication non-adherence in type 2 diabetes. J Endocrinol Invest 2019; 42 (05) 495-503 Review
- 9 Khunti K, Davies MJ. Clinical inertia-Time to reappraise the terminology?. Prim Care Diabetes 2017; 11 (02) 105-106
- 10 Mohan V. Expanding the concept of ‘clinical inertia’ in diabetes. J Diabetol 2019; 10: 1-3
- 11 O’Connor PJ, Sperl-Hillen JM, Johnson PE, Rush WA, Biltz G, Clinical inertia and outpatient medical errors. Agency for Healthcare Research and Quality. April 2005. Available at: http://www.ahrq.gov/downloads/pub/advances/vol2/OConnor.pdf. Accessed July 18, 2019.
- 12 Brown JB, Nichols GA, Perry A. The burden of treatment failure in type 2 diabetes. Diabetes Care 2004; 27 (07) 1535-1540
- 13 Unnikrishnan R, Mohan V. Why screening for type 2 diabetes is necessary even in poor resource settings. J Diabetes Complications 2015; 29 (07) 961-964
- 14 Satya Krishna SV, Kota SK, Modi KD. Glycemic variability: clinical implications. Indian J Endocrinol Metab 2013; 17 (04) 611-619
- 15 Lu J, Ma X, Zhou J. et al. Association of time in range, as assessed by continuous glucose monitoring, with diabetic retinopathy in type 2 diabetes. Diabetes Care 2018; 41 (11) 2370-2376