An observational study of clinical inertia among patients with type 2 diabetes mellitus in a tertiary care hospital
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PhD’s Degree Program in Pharmacy, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
Division of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, Thailand
Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai, Thailand
School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
Submission date: 2020-05-29
Final revision date: 2020-07-13
Acceptance date: 2020-07-19
Online publication date: 2020-08-20
Clinical inertia is a lack of treatment intensification despite a failure to achieve appropriate targets using a current management strategy. Research focusing on the clinical inertia in type 2 diabetes mellitus (T2DM) remains scant. This study aimed to investigate factors associated with clinical inertia among patients with T2DM.

Material and methods:
This observational study was conducted in a tertiary teaching hospital using medical records. T2DM patients attending the outpatient clinic between 1 January 2017 and 31 December 2017 were included. Failure to intensify the diabetes treatment of the participants was assessed. For this study, clinical inertia was defined as any T2DM patient event with an glycated haemoglobin (HbA1c) of ≥ 7.00% with no treatment intensification at the index date, or in a subsequent prescription written within the study time limits. Logistic regression analysis was used to determine associated factors.

Of 5756 T2DM outpatients, 994 patients were enrolled in this study, with 26.2% of patients presenting clinical inertia. This study found that factors associated with lower clinical inertia were the use of insulin, HbA1c level at the index date, lower number of antidiabetic drugs used, and treatment by specialists (all p-value < 0.05).

Clinical inertia is a problem of T2DM treatment. Strategies should be developed to decrease this problem.