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| '''Therapeutic inertia''' (also known as clinical inertia) is a measurement of the resistance to [[Therapy|therapeutic treatment]] for an existing [[medical condition]]. It is commonly measured as a percentage of the number of encounters in which a [[patient]] 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]] 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. | | I'm Yoshiko Oquendo. Interviewing is what I do for a residing but I strategy on altering it. Alabama has always been his home and his family loves it. One of the issues I adore most is greeting card gathering but I don't have the time lately.<br><br>Also visit my site: extended auto warranty ([http://brunswickjets.com/UserProfile/tabid/1126/userId/227159/Default.aspx click the next internet site]) |
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| ==Calculation==
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| 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 [[Hypertension|high blood pressure]] or [[Hypercholesterolemia|high cholesterol]]). In two of those visits, the provider made a change to the patient's treatment for the condition.
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| In Dr. Okonofua's original paper, this patient's therapeutic inertia is calculated as <math>\frac{h}{v} - \frac{c}{v}</math> 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.<ref name='okonofua'>{{cite journal|doi=10.1161/01.HYP.0000200702.76436.4b|url=http://hyper.ahajournals.org/cgi/content/abstract/47/3/345|title=Therapeutic Inertia Is an Impediment to Achieving the Healthy People 2010 Blood Pressure Control Goals|author=Eni C. Okonofua; Kit N. Simpson; Ammar Jesri; Shakaib U. Rehman; Valerie L. Durkalski; Brent M. Egan|journal=Hypertension|volume=47|issue=2006;47:345|pages=345–51|date=January 23, 2006|accessdate=2009-11-22|pmid=16432045}}</ref> Therefore, the patient's therapeutic inertia is <math>\frac{4}{5} - \frac{2}{5} = 0.4 = 40%</math>.
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| 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 <math>1 - \frac{c}{h}</math>. Using the above example, there are 2 changes and 4 visits with an uncontrolled condition. The therapeutic inertia is <math>1 - \frac{2}{4} = 0.5 = 50%</math>.
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| ==Reception==
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| Therapeutic inertia was devised as a metric for measuring treatment of hypertension. It has now become a standard metric for analysing treatment of common comorbidities such as diabetes<ref>[http://medicinetoday.com.au/home/article/view/481 Diabetes care: therapeutic inertia in doctors and patients]</ref> and hyperlipidemia.<ref>[http://www.jaoa.org/cgi/content/abstract/111/4_suppl_3/eS13 Getting Patients to Their Lipid Targets: A Practical Approach to Implementing Therapeutic Lifestyle Changes]</ref> Healthcare feedback reporting processes and intervention studies focused on therapeutic inertia reduction have been shown to increase control of hypertension (as well as diabetes and hyperlipidemia).<ref>[http://journals.lww.com/co-cardiology/Abstract/2011/07000/Is_blood_pressure_control_to_less_than_140_less.6.aspx 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>
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| ==References==
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| {{Reflist}}
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| ==External links==
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| *[http://oquin.musc.edu OQUIN]: The OQUIN:Hypertension Initiative at [[Medical University of South Carolina|MUSC]] performed the initial study and reporting on therapeutic inertia.
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| {{DEFAULTSORT:Therapeutic Inertia}}
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| [[Category:Medical terminology]]
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Latest revision as of 03:07, 3 January 2015
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