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Boon-How Chew 1 Article
Diabetes, Obesity and Metabolism
Overcoming Therapeutic Inertia as the Achilles’ Heel for Improving Suboptimal Diabetes Care: An Integrative Review
Boon-How Chew, Barakatun-Nisak Mohd-Yusof, Pauline Siew Mei Lai, Kamlesh Khunti
Endocrinol Metab. 2023;38(1):34-42.   Published online February 16, 2023
DOI: https://doi.org/10.3803/EnM.2022.1649
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  • 2 Web of Science
  • 3 Crossref
AbstractAbstract PDFPubReader   ePub   
The ultimate purpose of diabetes care is achieving the outcomes that patients regard as important throughout the life course. Despite advances in pharmaceuticals, nutraceuticals, psychoeducational programs, information technologies, and digital health, the levels of treatment target achievement in people with diabetes mellitus (DM) have remained suboptimal. This clinical care of people with DM is highly challenging, complex, costly, and confounded for patients, physicians, and healthcare systems. One key underlying problem is clinical inertia in general and therapeutic inertia (TI) in particular. TI refers to healthcare providers’ failure to modify therapy appropriately when treatment goals are not met. TI therefore relates to the prescribing decisions made by healthcare professionals, such as doctors, nurses, and pharmacists. The known causes of TI include factors at the level of the physician (50%), patient (30%), and health system (20%). Although TI is often multifactorial, the literature suggests that 28% of strategies are targeted at multiple levels of causes, 38% at the patient level, 26% at the healthcare professional level, and only 8% at the healthcare system level. The most effective interventions against TI are shorter intervals until revisit appointments and empowering nurses, diabetes educators, and pharmacists to review treatments and modify prescriptions.

Citations

Citations to this article as recorded by  
  • Obesity management from the perspectives of people living with obesity in Canada: A mixed‐methods study
    David C. W. Lau, Ian Patton, Reena Lavji, Adel Belloum, Ginnie Ng, Renuca Modi
    Diabetes, Obesity and Metabolism.2024; 26(4): 1529.     CrossRef
  • Using continuous glucose monitoring to measure and improve quality metrics: Updates on the Healthcare Effectiveness Data and Information Set 2024 Glucose Management Indicator measure
    Marissa Morris-Murray, Marie Frazzitta
    Journal of Managed Care & Specialty Pharmacy.2024; 30(10-b Suppl): S30.     CrossRef
  • Bridging the gap in cardiovascular care in diabetic patients: are cardioprotective antihyperglycemic agents underutilized?
    André J Scheen
    Expert Review of Clinical Pharmacology.2023; 16(11): 1053.     CrossRef
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