Predictors of Clinical Inertia and Type 2 Diabetes: Assessment of Primary Care Physicians and Their Patients

Nemanja Isajev, Vesna Bjegovic-Mikanovic, Zoran Bukumiric, David Vrhovac and Nebojsa M. Lalic
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Nemanja Isajev: Centre School of Public Health and Management, Faculty of Medicine, University of Belgrade, dr Subotica 15, 11000 Belgrade, Serbia
Vesna Bjegovic-Mikanovic: Centre School of Public Health and Management, Faculty of Medicine, University of Belgrade, dr Subotica 15, 11000 Belgrade, Serbia
Zoran Bukumiric: Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, dr Subotica 15, 11000 Belgrade, Serbia
David Vrhovac: University Children’s Hospital, Tirsova 10, 11000 Belgrade, Serbia
Nebojsa M. Lalic: Clinic for Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, dr Subotica 13, 11000 Belgrade, Serbia

IJERPH, 2022, vol. 19, issue 8, 1-18

Abstract: With the growing prevalence and complex pathophysiology of type 2 diabetes, many patients fail to achieve treatment goals despite guidelines and possibilities for treatment individualization. One of the identified root causes of this failure is clinical inertia. We explored this phenomenon, its possible predictors, and groups of patients affected the most, together with offering potential paths for intervention. Our research was a cross-sectional study conducted during 2021 involving 52 physicians and 543 patients of primary healthcare institutions in Belgrade, Serbia. The research instruments were questionnaires based on similar studies, used to collect information related to the factors that contribute to developing clinical inertia originating in both physicians and patients. In 224 patients (41.3%), clinical inertia was identified in patients with poor overall health condition, long diabetes duration, and comorbidities. Studying the changes made to the treatment, most patients (53%) had their treatment adjustment more than a year ago, with 19.3% of patients changing over the previous six months. Moreover, we found significant inertia in the treatment of patients using modern insulin analogues. Referral to secondary healthcare institutions reduced the emergence of inertia. This assessment of primary care physicians and their patients pointed to the high presence of clinical inertia, with an overall health condition, comorbidities, diabetes duration, current treatment, last treatment change, glycosylated hemoglobin and fasting glucose measuring frequency, BMI, patient referral, diet adjustment, and physician education being significant predictors.

Keywords: diabetes type 2; clinical inertia; diabetes care; physician inertia; primary care physicians; glycemic control (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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