254:
Therapeutic inertia was devised as a metric for measuring treatment of hypertension. It has now become a standard metric for analysing treatment of many common comorbidities such as diabetes and hyperlipidemia. Both feedback reporting processes and intervention studies aimed at reducing therapeutic
43:
There are two common methods used in calculating therapeutic inertia. For the following examples, consider that a patient has five visits with a health provider. In four of those visits, a condition is not controlled (such as
160:
93:
244:
31:
with a condition received new or increased therapeutic treatment out of the total number of visits to a health care professional by the patient. A high percentage indicates that the
196:
35:
is slow to treat a medical condition. A low percentage indicates that a provider is extremely quick in prescribing new treatment at the onset of any medical condition.
165:
An alternative, which avoids consideration of visits where the condition was already controlled and the provider should not be expected to make a treatment change, is
377:
Is blood pressure control to less than 140/less than 90 mmHg in 50% of all hypertensive patients as good as we can do in the USA: or is this as good as it gets?
376:
293:
395:
110:
314:
Eni C. Okonofua; Kit N. Simpson; Ammar Jesri; Shakaib U. Rehman; Valerie L. Durkalski; Brent M. Egan (January 23, 2006).
198:. Using the above example, there are 2 changes and 4 visits with an uncontrolled condition. The therapeutic inertia is
411:
58:
201:
366:
Getting
Patients to Their Lipid Targets: A Practical Approach to Implementing Therapeutic Lifestyle Changes
316:"Therapeutic Inertia Is an Impediment to Achieving the Healthy People 2010 Blood Pressure Control Goals"
168:
52:). In two of those visits, the provider made a change to the patient's treatment for the condition.
49:
32:
365:
337:
289:
24:
327:
281:
255:
inertia have been shown to increase control of hypertension, diabetes, and hyperlipidemia.
332:
315:
55:
In Dr. Okonofua's original paper, this patient's therapeutic inertia is calculated as
405:
354:
45:
27:. It is commonly measured as a percentage of the number of encounters in which a
273:
285:
107:
is the total number of visits. Therefore, the patient's therapeutic inertia is
341:
28:
20:
19:(also known as clinical inertia) is a measurement of the resistance to
398:
performed the initial study and reporting on therapeutic inertia.
274:"To Do or Not to Do: A Critique of Medical Reason medical reason"
280:, Cham: Springer International Publishing, pp. 73–95,
355:
Diabetes care: therapeutic inertia in doctors and patients
391:
103:
is the number of visits in which a change was made, and
99:
is the number of visits with an uncontrolled condition,
155:{\displaystyle {\frac {4}{5}}-{\frac {2}{5}}=0.4=40\%}
204:
171:
113:
61:
238:
190:
154:
87:
88:{\displaystyle {\frac {h}{v}}-{\frac {c}{v}}}
8:
331:
239:{\displaystyle 1-{\frac {2}{4}}=0.5=50\%}
211:
203:
178:
170:
127:
114:
112:
75:
62:
60:
394:: The OQUIN:Hypertension Initiative at
264:
7:
333:10.1161/01.HYP.0000200702.76436.4b
233:
149:
14:
191:{\displaystyle 1-{\frac {c}{h}}}
1:
272:Reach, Gérard (2014-09-12),
286:10.1007/978-3-319-09882-1_6
428:
326:(2006, 47:345): 345–51.
240:
192:
156:
89:
241:
193:
157:
90:
21:therapeutic treatment
202:
169:
111:
59:
33:health care provider
412:Medical terminology
46:high blood pressure
17:Therapeutic inertia
236:
188:
152:
85:
295:978-3-319-09881-4
219:
186:
135:
122:
83:
70:
25:medical condition
419:
379:
374:
368:
363:
357:
352:
346:
345:
335:
311:
305:
304:
303:
302:
278:Clinical Inertia
269:
245:
243:
242:
237:
220:
212:
197:
195:
194:
189:
187:
179:
161:
159:
158:
153:
136:
128:
123:
115:
94:
92:
91:
86:
84:
76:
71:
63:
50:high cholesterol
23:for an existing
427:
426:
422:
421:
420:
418:
417:
416:
402:
401:
388:
383:
382:
375:
371:
364:
360:
353:
349:
313:
312:
308:
300:
298:
296:
271:
270:
266:
261:
252:
200:
199:
167:
166:
109:
108:
57:
56:
41:
12:
11:
5:
425:
423:
415:
414:
404:
403:
400:
399:
387:
386:External links
384:
381:
380:
369:
358:
347:
306:
294:
263:
262:
260:
257:
251:
248:
235:
232:
229:
226:
223:
218:
215:
210:
207:
185:
182:
177:
174:
151:
148:
145:
142:
139:
134:
131:
126:
121:
118:
82:
79:
74:
69:
66:
40:
37:
13:
10:
9:
6:
4:
3:
2:
424:
413:
410:
409:
407:
397:
393:
390:
389:
385:
378:
373:
370:
367:
362:
359:
356:
351:
348:
343:
339:
334:
329:
325:
321:
317:
310:
307:
297:
291:
287:
283:
279:
275:
268:
265:
258:
256:
249:
247:
230:
227:
224:
221:
216:
213:
208:
205:
183:
180:
175:
172:
163:
146:
143:
140:
137:
132:
129:
124:
119:
116:
106:
102:
98:
80:
77:
72:
67:
64:
53:
51:
47:
38:
36:
34:
30:
26:
22:
18:
372:
361:
350:
323:
320:Hypertension
319:
309:
299:, retrieved
277:
267:
253:
164:
104:
100:
96:
54:
42:
16:
15:
39:Calculation
301:2020-12-19
259:References
250:Reception
234:%
209:−
176:−
150:%
125:−
73:−
406:Category
342:16432045
29:patient
340:
292:
95:where
392:OQUIN
396:MUSC
338:PMID
290:ISBN
328:doi
282:doi
225:0.5
141:0.4
48:or
408::
336:.
324:47
322:.
318:.
288:,
276:,
246:.
231:50
162:.
147:40
344:.
330::
284::
228:=
222:=
217:4
214:2
206:1
184:h
181:c
173:1
144:=
138:=
133:5
130:2
120:5
117:4
105:v
101:c
97:h
81:v
78:c
68:v
65:h
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.