Clinical inertia and its impact on treatment intensification in people with type 2 diabetes mellitus

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G Reach1, V Pechtner2, R Gentilella3

  • 1Department of Endocrinology, Diabetes and Metabolic Diseases, Avicenne Hospital APHP and EA 3412, CRNH-IdF, Paris 13 University, 93017 Bobigny, France.

Diabetes & Metabolism
|July 30, 2017
PubMed

Insights

Clinical inertia, the delay in intensifying type 2 diabetes mellitus (T2DM) treatment, leads to poor glycaemic control. Addressing this requires multifaceted solutions, including person-centered care and improved patient education on T2DM progression.

Area of Science:

  • Endocrinology
  • Diabetes Management
  • Healthcare Policy

Background:

  • Type 2 diabetes mellitus (T2DM) management often faces delays in treatment intensification, impacting patient outcomes.
  • Clinical inertia, defined as the failure to initiate or intensify therapy when indicated, is a significant barrier in T2DM care.
  • Factors contributing to clinical inertia include physician, patient, and healthcare system elements, alongside 'apparent' clinical inertia reflecting sound clinical judgment.

Purpose of the Study:

  • To explore the phenomenon of clinical inertia in type 2 diabetes mellitus (T2DM) management.
  • To identify the contributing factors to delayed treatment intensification in T2DM.
  • To discuss potential strategies for overcoming clinical inertia and improving glycaemic control.

Main Methods:

  • Literature review and synthesis of factors contributing to clinical inertia in T2DM.
  • Analysis of the impact of delayed treatment intensification on patient morbidity, mortality, and public health costs.
  • Exploration of potential solutions, including person-centered care models and enhanced patient education.

Main Results:

  • Clinical inertia occurs at all stages of T2DM treatment, from lifestyle changes to insulin initiation.
  • Delayed intensification leads to prolonged suboptimal glycaemic control, negatively affecting quality of life and increasing mortality.
  • The economic burden of uncontrolled T2DM is substantial due to long-term complications.

Conclusions:

  • Clinical inertia in T2DM management has severe consequences for individuals and public health.
  • Addressing clinical inertia necessitates a combination of approaches, including fundamental changes in medical care delivery.
  • Implementing person-centered care and improving patient education are key strategies to enhance treatment adherence and timely intensification.
Keywords:
Clinical inertiaPatient-related factorsPhysician-related factorsSystem-related factorsTreatment outcomesType 2 diabetes mellitus

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