Samuel Seidu1, Tun Than2, Deb Kar2, Amrit Lamba3, Pam Brown4, Azhar Zafar2, Rizwan Hussain5, Ahmed Amjad6, Mathew Capehorn7, Elizabeth Martin8, Kevin Fernando9, Jim McMoran10, David Millar-Jones11, Shahzada Kahn12, Nigel Campbell13, Richard Brice14, Rahul Mohan15, Mukesh Mistry10, Naresh Kanumilli16, Joan St John17, Richard Quigley18, Colin Kenny19, Kamlesh Khunti2. 1. Diabetes Research Centre, Gwendolen Road, Leicester General Hospital, Leicester LE5 4WP, United Kingdom. Electronic address: sis11@le.ac.uk. 2. Diabetes Research Centre, Gwendolen Road, Leicester General Hospital, Leicester LE5 4WP, United Kingdom. 3. Colindale Medical Centre, 61 Colindeep Lane, Colindale, London, NW9 6DJ, United Kingdom. 4. Kings Road Surgery, Mumbles, Swansea, United Kingdom. 5. Avicenna Medical Centre, United Kingdom. 6. Cheetham Hill Primary Care Centre, 244 Cheetham Hill Road, Manchester, Greater Manchester, M8 8UP, United Kingdom. 7. Clifton Medical Centre, Rotheram, United Kingdom. 8. Diabetes Department, St. James Teaching Hospital, United Kingdom. 9. North Berwick Health Centre, North Berwick Group Practice, 54 St. Baldred's Road, North Berwick, EH39 4PU, United Kingdom. 10. The Community Diabetes and Cardiovascular Risk Clinic service is based on the first floor Spires Suite of City of Coventry Health Centre, 2 Stoney Stanton Road, Coventry CV1 4FS, United Kingdom. 11. Oak Street, Cwmbran, Gwent, NP44 3LT, United Kingdom. 12. Vicarage Lane Health Centre, 10 Vicarage Lane, Stratford, London, Greater London, E15 4ES, United Kingdom. 13. Lisburn Health Centre, Linenhall Street, Lisburn, BT28 1LU, United Kingdom. 14. Estuary View Medical Centre, Boorman Way, Whitstable, CT5 3SE, United Kingdom. 15. Church House Surgery, Shaw Street, NG11 6HF Ruddington, United Kingdom. 16. Northenden Group Practice, Stockport, Manchester, M22 4DH, UK. 17. Law Medical Group Practice, Wembley and Willesden, United Kingdom. 18. Thornliebank Health Centre, 20 Kennishead Road, Glasgow, G46 8NY, United Kingdom. 19. Retired GP, Dromore, Co Down, UK.
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.
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 patientpatients with diabetes being managed by primary care physicians with an interest in diabetes.
Authors: Nemanja Isajev; Vesna Bjegovic-Mikanovic; Zoran Bukumiric; David Vrhovac; Nebojsa M Lalic Journal: Int J Environ Res Public Health Date: 2022-04-07 Impact factor: 4.614