Clinical inertia tied to worse long-term outcomes in diabetics

Among patients with type 2 diabetes, clinical inertia appears to worsen long-term glycaemic control, reports a recent study.

Researchers conducted a retrospective analysis of 1,483 diabetes patients (median age 59 years, 64.2 men) who had been treated with a single oral diabetic drug. Clinical inertia was defined as the failure of healthcare providers to intensify treatment, as was measured in the present analysis as the time to such intensification. Participants’ glycaemic control and renal function were followed for 2 years.

More than a third (35.5 percent) of patients faced clinical inertia, with a median time to treatment intensification of 75.5 days from index date. Among those with clinical inertia, 33.8 percent achieved the haemoglobin A1c target of <7.0%. Meanwhile, this threshold was reached by 47.9 percent of those without clinical inertia.

Multivariate logistic regression analysis found that haemoglobin A1c ≥8.0% was a significant protective factor against clinical inertia (adjusted odds ratio [OR], 0.41, 95 percent confidence interval [CI], 0.29–0.56; p<0.0001), as was having hyperlipidaemia (adjusted OR, 0.76, 95 percent CI, 0.61–0.95; p=0.0179).

Meanwhile, having a higher Charlson Comorbidity Index increased the likelihood of clinical inertia (adjusted OR, 1.07, 95 percent CI, 1.01–1.13; p=0.0227). The same was true for longer between-visit intervals (≥10 vs <6 weeks: adjusted OR, 1.74, 95 percent CI, 1.28–2.38; p=0.0005).

“Our findings will inform clinicians of the characteristics of patients associated with clinical inertia and the importance of providing appropriate treatment under clinical practice guidelines,” the researchers said.