Therapeutic inertia (also known as clinical inertia) is a measurement of the resistance to
therapeutic treatment for an existing
medical condition
A disease is a particular abnormal condition that negatively affects the structure or function (biology), function of all or part of an organism, and that is not immediately due to any external injury. Diseases are often known to be medica ...
. It is commonly measured as a percentage of the number of encounters in which a
patient
A patient is any recipient of health care services that are performed by healthcare professionals. The patient is most often ill or injured and in need of treatment by a physician, nurse, optometrist, dentist, veterinarian, or other health c ...
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
health care provider
A health care provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices. Health care providers often receive ...
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.
Calculation
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
high blood pressure
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high bl ...
or
high cholesterol
Hypercholesterolemia, also called high cholesterol, is the presence of high levels of cholesterol in the blood. It is a form of hyperlipidemia (high levels of lipids in the blood), hyperlipoproteinemia (high levels of lipoproteins in the blood), ...
). In two of those visits, the provider made a change to the patient's treatment for the condition.
In Dr. Okonofua's original paper, this patient's therapeutic inertia is calculated as
where ''h'' is the number of visits with an uncontrolled condition, ''c'' is the number of visits in which a change was made, and ''v'' is the total number of visits.
Therefore, the patient's therapeutic inertia is
.
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
. Using the above example, there are 2 changes and 4 visits with an uncontrolled condition. The therapeutic inertia is
.
Reception
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 inertia have been shown to increase control of hypertension,
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?
/ref> diabetes, and hyperlipidemia.
References
External links
OQUIN
The OQUIN:Hypertension Initiative at MUSC performed the initial study and reporting on therapeutic inertia.
{{DEFAULTSORT:Therapeutic Inertia
Medical terminology