Overcoming Therapeutic Inertia as the Achilles’ Heel for Improving Suboptimal Diabetes Care: An Integrative Review
The ultimate purpose of diabetes care is achieving the outcomes that patients regard as important throughout the life course. Despite advances in pharmaceuticals, nutraceuticals, psychoeducational programs, information technologies, and digital health, the levels of treatment target achievement in p...
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| Format: | Article |
| Language: | English |
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Korean Endocrine Society
2023-02-01
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| Series: | Endocrinology and Metabolism |
| Subjects: | |
| Online Access: | http://www.e-enm.org/upload/pdf/enm-2022-1649.pdf |
| _version_ | 1811158261442805760 |
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| author | Boon-How Chew Barakatun-Nisak Mohd-Yusof Pauline Siew Mei Lai Kamlesh Khunti |
| author_facet | Boon-How Chew Barakatun-Nisak Mohd-Yusof Pauline Siew Mei Lai Kamlesh Khunti |
| author_sort | Boon-How Chew |
| collection | DOAJ |
| description | The ultimate purpose of diabetes care is achieving the outcomes that patients regard as important throughout the life course. Despite advances in pharmaceuticals, nutraceuticals, psychoeducational programs, information technologies, and digital health, the levels of treatment target achievement in people with diabetes mellitus (DM) have remained suboptimal. This clinical care of people with DM is highly challenging, complex, costly, and confounded for patients, physicians, and healthcare systems. One key underlying problem is clinical inertia in general and therapeutic inertia (TI) in particular. TI refers to healthcare providers’ failure to modify therapy appropriately when treatment goals are not met. TI therefore relates to the prescribing decisions made by healthcare professionals, such as doctors, nurses, and pharmacists. The known causes of TI include factors at the level of the physician (50%), patient (30%), and health system (20%). Although TI is often multifactorial, the literature suggests that 28% of strategies are targeted at multiple levels of causes, 38% at the patient level, 26% at the healthcare professional level, and only 8% at the healthcare system level. The most effective interventions against TI are shorter intervals until revisit appointments and empowering nurses, diabetes educators, and pharmacists to review treatments and modify prescriptions. |
| first_indexed | 2024-04-10T05:20:25Z |
| format | Article |
| id | doaj.art-8c2fb783c88f4a0192166128ad3daf9b |
| institution | Directory Open Access Journal |
| issn | 2093-596X 2093-5978 |
| language | English |
| last_indexed | 2024-04-10T05:20:25Z |
| publishDate | 2023-02-01 |
| publisher | Korean Endocrine Society |
| record_format | Article |
| series | Endocrinology and Metabolism |
| spelling | doaj.art-8c2fb783c88f4a0192166128ad3daf9b2023-03-08T07:43:19ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782023-02-01381344210.3803/EnM.2022.16492370Overcoming Therapeutic Inertia as the Achilles’ Heel for Improving Suboptimal Diabetes Care: An Integrative ReviewBoon-How Chew0Barakatun-Nisak Mohd-Yusof1Pauline Siew Mei Lai2Kamlesh Khunti3 Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia National Institute for Health Research Applied Research Collaboration East Midlands, Leicester Diabetes Centre, UKThe ultimate purpose of diabetes care is achieving the outcomes that patients regard as important throughout the life course. Despite advances in pharmaceuticals, nutraceuticals, psychoeducational programs, information technologies, and digital health, the levels of treatment target achievement in people with diabetes mellitus (DM) have remained suboptimal. This clinical care of people with DM is highly challenging, complex, costly, and confounded for patients, physicians, and healthcare systems. One key underlying problem is clinical inertia in general and therapeutic inertia (TI) in particular. TI refers to healthcare providers’ failure to modify therapy appropriately when treatment goals are not met. TI therefore relates to the prescribing decisions made by healthcare professionals, such as doctors, nurses, and pharmacists. The known causes of TI include factors at the level of the physician (50%), patient (30%), and health system (20%). Although TI is often multifactorial, the literature suggests that 28% of strategies are targeted at multiple levels of causes, 38% at the patient level, 26% at the healthcare professional level, and only 8% at the healthcare system level. The most effective interventions against TI are shorter intervals until revisit appointments and empowering nurses, diabetes educators, and pharmacists to review treatments and modify prescriptions.http://www.e-enm.org/upload/pdf/enm-2022-1649.pdfdiabetes mellitustherapeuticsmedication adherence |
| spellingShingle | Boon-How Chew Barakatun-Nisak Mohd-Yusof Pauline Siew Mei Lai Kamlesh Khunti Overcoming Therapeutic Inertia as the Achilles’ Heel for Improving Suboptimal Diabetes Care: An Integrative Review Endocrinology and Metabolism diabetes mellitus therapeutics medication adherence |
| title | Overcoming Therapeutic Inertia as the Achilles’ Heel for Improving Suboptimal Diabetes Care: An Integrative Review |
| title_full | Overcoming Therapeutic Inertia as the Achilles’ Heel for Improving Suboptimal Diabetes Care: An Integrative Review |
| title_fullStr | Overcoming Therapeutic Inertia as the Achilles’ Heel for Improving Suboptimal Diabetes Care: An Integrative Review |
| title_full_unstemmed | Overcoming Therapeutic Inertia as the Achilles’ Heel for Improving Suboptimal Diabetes Care: An Integrative Review |
| title_short | Overcoming Therapeutic Inertia as the Achilles’ Heel for Improving Suboptimal Diabetes Care: An Integrative Review |
| title_sort | overcoming therapeutic inertia as the achilles heel for improving suboptimal diabetes care an integrative review |
| topic | diabetes mellitus therapeutics medication adherence |
| url | http://www.e-enm.org/upload/pdf/enm-2022-1649.pdf |
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