Acknowledging and allocating responsibility for clinical inertia in the management of Type 2 diabetes in primary care: a qualitative study

Most participants could offer relevant explanations of the concept of clinical inertia despite being unaware of the term.

“Surprisingly, Zafar et al. [27] reported that most of the participants (physician or nurse) were unaware of the term “clinical inertia” or its meaning, but they could offer relevant explanations of the concept.”

Most participants (physicians or nurses) were unaware of the term "clinical inertia" or its meaning.

“Zafar et al. [27] reported that most of the participants were unaware of the term “clinical inertia”.”

Patient-level barriers to treatment intensification include non-compliance to prescribed medications, failure to attend appointments, conflicting priorities, lack of awareness about the fatality of type 2 diabetes mellitus, lack of symptoms, human error, comorbidities, polypharmacy, complex nature of the disease, deprivation, and communication barrier.

“At the patient level, barriers included non-compliance to prescribed medications, failure to attend appointments, conflicting priorities (such as perceptions, beliefs, or work commitments), lack of awareness about the fatality of T2DM, lack of symptoms, human error, comorbidities, polypharmacy, complex nature of the disease, deprivation, and communication barrier [27].”

Some physicians admit their responsibility for clinical inertia because they think health professional factors far outweigh factors at the patients' end.

“Interestingly, at the provider level, some of the physicians admit their responsibility for clinical inertia because they think that health professional factors far outweigh the factors at the patients’ end.”

Some physicians directly blamed their patients for not complying with instructions or not visiting their clinic on time.

“At the same time, some physicians directly blamed their patients for not complying with their instructions or not visiting their clinic on time [27].”

Some physicians think they should be firmer to reach the target HbA1c.

“They also think that they should be a bit firmer to reach the target HbA1c [27].”

Some physicians defended their patients by referring to a lack of knowledge and took responsibility for not improving their patients' awareness.

“Even some physicians defended their patients by referring to a lack of knowledge and taking the responsibility by not improving their patients’ awareness.”