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Promoters of therapeutic inertia in managing hypertension: a consensus-based study

Ramzi Shawahna1, Soraida Khalaily, Doaa Abu Saleh

  • 1Department of Physiology, Pharmacology, and Toxicology, Faculty of Medicine and Health Sciences, New Campus, An-Najah National University, PO Box 7, Building 19, Office 1340, Nablus, Palestine.

The American Journal of Managed Care
|November 16, 2021
PubMed

Insights

Therapeutic inertia is common in hypertension management in Palestine, with most identified causes related to clinicians, patients, and the healthcare system. Addressing these factors is crucial for improving patient outcomes.

Area of Science:

  • Cardiology
  • General Practice
  • Health Policy

Background:

  • Hypertension is a prevalent condition managed frequently in primary care.
  • Therapeutic inertia, a delay in treatment intensification, contributes significantly to cardiovascular events in hypertensive patients.
  • Understanding the drivers of therapeutic inertia is essential for effective hypertension management.

Purpose of the Study:

  • To explore clinicians' perspectives on therapeutic inertia in hypertension management in Palestine.
  • To achieve consensus on the factors promoting therapeutic inertia in this clinical setting.

Main Methods:

  • A mixed-methods approach was employed, including literature review, qualitative interviews with 18 clinicians, and two Delphi rounds with 50 specialists.
  • The Delphi technique was used to reach formal consensus on the promoters of therapeutic inertia.

Main Results:

  • 90% of clinicians perceived therapeutic inertia as prevalent in Palestinian hypertension care.
  • Consensus was reached on 37 out of 41 potential promoters of therapeutic inertia.
  • The identified promoters were categorized as clinician-related (56.8%), patient-related (27.0%), and health care system-related (16.2%).

Conclusions:

  • The findings highlight significant clinician, patient, and system-level factors contributing to therapeutic inertia in hypertension management in Palestine.
  • These insights can guide policymakers in developing strategies to mitigate therapeutic inertia.
  • Further research is needed to evaluate the impact of implemented strategies on patient outcomes.
Abstract

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