Therapeutic inertia
Therapeutic inertia is a measurement of the resistance to therapeutic treatment for an existing medical condition. It is commonly measured as percentage of the number of encounters in which a patient with a condition received new or increased therapeutic treatment out of the total number of visits in which a patient had a condition.
<math>\frac{h}{v} - \frac{c}{v}</math>
...where h is the number of visits with an uncontrolled condition, c is the number of visits in which a change was made, and v is the total number of visits[1].
A high percentage indicates that the health care provider is slow to treat a medical condition. A low percentage indicates that a provider is extremely quick in prescribing new treatment at the onset of any medical condition.
Examples
- Diabetes mellitus[2][3][4][5]
- Hypercholesterolemia: two-thirds of patients with statin indications had not been offered statins in one registry study[6]
- Hypertension. Therapeutic inertia may contribute to the finding that in the US 62%, and in Europe 85%, of office visits with a high blood pressure the health care provider does not increase medications.[7] The magnitude of inertia may change over time in response to emerging research on hypertension[8].
Causes
One cause may be health disparities[9].
See also
External links
References
- ↑ Okonofua EC, Simpson KN, Jesri A, Rehman SU, Durkalski VL, Egan BM (2006). "Therapeutic inertia is an impediment to achieving the Healthy People 2010 blood pressure control goals". Hypertension. 47 (3): 345–51. doi:10.1161/01.HYP.0000200702.76436.4b. PMID 16432045.
- ↑ Karam SL, Dendy J, Polu S, Blonde L (2020). "Overview of Therapeutic Inertia in Diabetes: Prevalence, Causes, and Consequences". Diabetes Spectr. 33 (1): 8–15. doi:10.2337/ds19-0029. PMC 7026754 Check
|pmc=value (help). PMID 32116448 Check|pmid=value (help). - ↑ Khunti S, Khunti K, Seidu S (2019). "Therapeutic inertia in type 2 diabetes: prevalence, causes, consequences and methods to overcome inertia". Ther Adv Endocrinol Metab. 10: 2042018819844694. doi:10.1177/2042018819844694. PMC 6502982 Check
|pmc=value (help). PMID 31105931. - ↑ Brunton S. Therapeutic Inertia is a Problem for All of Us. Clinical Diabetes 2019 Apr; 37(2): 105-106. doi:10.2337/cd19-0009
- ↑ Simon D (2012). "Therapeutic inertia in type 2 diabetes: insights from the PANORAMA study in France". Diabetes Metab. 38 Suppl 3: S47–52. doi:10.1016/S1262-3636(12)71534-3. PMID 22541602.
- ↑ Bradley CK, Wang TY, Li S, Robinson JG, Roger VL, Goldberg AC; et al. (2019). "Patient-Reported Reasons for Declining or Discontinuing Statin Therapy: Insights From the PALM Registry". J Am Heart Assoc. 8 (7): e011765. doi:10.1161/JAHA.118.011765. PMC 6509731 Check
|pmc=value (help). PMID 30913959. - ↑ Wang YR, Alexander GC, Stafford RS (2007). "Outpatient hypertension treatment, treatment intensification, and control in Western Europe and the United States". Arch Intern Med. 167 (2): 141–7. doi:10.1001/archinte.167.2.141. PMID 17242314.
- ↑ Ambrož M, de Vries ST, Sidorenkov G, Hoogenberg K, Denig P (2020). "Changes in blood pressure thresholds for initiating antihypertensive medication in patients with diabetes: a repeated cross-sectional study focusing on the impact of age and frailty". BMJ Open. 10 (9): e037694. doi:10.1136/bmjopen-2020-037694. PMC 7485238 Check
|pmc=value (help). PMID 32912988 Check|pmid=value (help). - ↑ Egan BM, Laken MA (2011). "Is blood pressure control to less than 140/less than 90 mmHg in 50% of all hypertensive patients as good as we can do in the USA: or is this as good as it gets?". Curr Opin Cardiol. 26 (4): 300–7. doi:10.1097/HCO.0b013e3283474c20. PMID 21597369.