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Clinical inertia is defined as delay of treatment intensification in a patient not at their therapeutic goal. Clinical inertia is a major factor that contributes to inadequate chronic disease care in patients with diabetes, hypertension, dyslipidemia, depression, heart disease, and other chronic conditions. Recent research suggests that clinical inertia related to the management of diabetes, hypertension and dyslipidemia may contribute to up to 80 percent of heart attacks and strokes. Clinical inertia is the leading cause of potentially preventable adverse events, disability, death, and excess medical care costs.
What can you do about this? Primary care is typically unplanned, and at times chaotic unlike the clinical trials which are designed to provide
planned care
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Three features have been found to dramatically improve care and reduce clinical inertia;
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Frequent, carefully planned office visits,
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Timely and tailored decision support for providers to prompt appropriate initiation and
adjustment of medications until specified clinical goals are achieved.
Planned care with frequent visits may reduce clinical inertia in office practices because:
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Provider has more opportunity to intensify care
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Frequent visits send the message to the patient that intensification of treatment is important and anticipated.
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Allows for rapid titration to clinical goals
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The provider and patient learn that frequent medication adjustments are a
predictable part of excellent chronic disease care, rather than a sign of failed therapy.
Decision support tools do not have to be EMR based to be effective;
patient tailored information, however delivered, based on simple treatment protocols can lead to improved blood pressure, HbA1c and lipid control.
Alison M Gustafson NP NEPHO
Population Health Nurse Practitioner
978-882-2454
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