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Cited by 17Diabetes Treatment and ManagementDiabetes Management and EducationDiabetes Management and Research

Therapeutic inertia amongst general practitioners with interest in diabetes

Seidu, Samuel, Than, Tun, Kar, Deb, Lamba, Amrit, Brown, Pam, Zafar, Azhar, Hussain, Rizwan, Amjad, Ahmed +15 more·2018·Primary Care Diabetes
DOI 10.1016/j.pcd.2017.09.001
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Abstract

Introduction As the therapeutic options in the management of type 2 diabetes increase, there is an increase confusion among health care professionals, thus leading to the phenomenon of therapeutic inertia. This is the failure to escalate or de-escalate treatment when the clinical need for this is required. It has been studied extensively in various settings, however, it has never been reported in any studies focusing solely on primary care physicians with an interest in diabetes. This group is increasingly becoming the focus of managing complex diabetes care in the community, albeit with the support from specialists. Methods In this retrospective audit, we assessed the prevalence of the phenomenon of therapeutic inertia amongst primary care physicians with an interest in diabetes in UK. We also assessed the predictive abilities of various patient level characteristics on therapeutic inertia amongst this group of clinicians. Results Out of the 240 patients reported on, therapeutic inertia was judged to have occurred in 53 (22.1%) of patients. The full model containing all the selected variables was not statistically significant, p=0.59. So the model was not able to distinguish between situations in which therapeutic inertia occurred and when it did not occur. None of the patient level characteristics on its own was predictive of therapeutic inertia. Conclusion Therapeutic inertia was present only in about a fifth of patient patients with diabetes being managed by primary care physicians with an interest in diabetes.

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  • Clinical inertia levels are not related to health spending.

    “Surprisingly the level of clinical inertia levels seen here were not related to health spending; for example, the highest clinical inertia was reported in a study conducted in the United States despite the high healthcare spending in USA [32].”

    From Clinical Inertia in the Management of Type 2 Diabetes Mellitus: A Systematic Review (2023) · cites this paper as [32]

    The Discussion (page unavailable) reports that 27% of patients in a Michigan practice had sustained hyperglycaemia without medication intensification, supporting the example of inertia in the United States. It does not establish that this was the highest level or compare inertia with national health spending; the Discussion says the relationship between diabetes-drug costs and therapeutic inertia remains largely unknown. (LLM, conf=0.78)

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  • The highest clinical inertia was reported in a study conducted in the United States despite high healthcare spending in the USA.

    “Surprisingly the level of clinical inertia levels seen here were not related to health spending; for example, the highest clinical inertia was reported in a study conducted in the United States despite the high healthcare spending in USA [32].”

    From Clinical Inertia in the Management of Type 2 Diabetes Mellitus: A Systematic Review (2023) · cites this paper as [32]

    The Discussion reports a Michigan study in which 27% of patients had sustained hyperglycaemia without medication intensification; the Results report therapeutic inertia in 22.1% of this paper’s UK patients. The paper does not establish that the US study had the highest level of clinical inertia, nor does it compare that level with US healthcare spending. (LLM, conf=0.85)

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Research works printed but not linked: 1

  1. [18]18. Diabetes claims against doctors on the increase says MDU . https://www.themdu.com/presscentre/press-releases/diabetes-claims-against-doctors-on-the-increase-says-mdu. Updated 2015.

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Authors
Seidu, S., Than, T., Kar, D., Lamba, A., Brown, P., Zafar, A., Hussain, R., Amjad, A., Capehorn, M., Martin, E., Fernando, K., McMoran, J., Millar-Jones, D., Kahn, S., Campbell, N., Brice, R., Mohan, R., Mistry, M., Kanumilli, N., St. John, J., Quigley, R., Kenny, C., & Khunti, K.
Affiliations
  • Leicester General Hospital (GB)
  • NHS Greater Glasgow and Clyde (GB)
Corresponding author
Seidu, Samuel
ORCID
Venue
Primary Care Diabetes
Publisher
Elsevier BV
Published
2018-02
Volume
12
Issue
1
Pages
87-91
ISSN
1751-9918 (ISSN-L)
DOI
10.1016/j.pcd.2017.09.001
OpenAlex
W2762866754
Cited by
17
References
21
Citations by year
2024: 4 · 2023: 4 · 2022: 3 · 2021: 1 · 2020: 2 · 2018: 3
FWCI
1.08
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Primary care diabetes (publishedVersion)
  • PubMed (publishedVersion)
  • White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
  • PEARL (University of Plymouth) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
therapeutic inertia, type 2 diabetes, general practitioners, primary care physicians, diabetes management, treatment escalation and de-escalation, prevalence, patient characteristics
MeSH terms
Aged, Attitude of Health Personnel, Blood Glucose, Diabetes Mellitus, Type 2, Female, United Kingdom, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Health Knowledge, Attitudes, Practice, Male, Medical Audit, Middle Aged, Practice Patterns, Physicians', Primary Health Care, Retrospective Studies, Risk Factors, Biomarkers, Practice Guidelines as Topic, Guideline Adherence, General Practitioners

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