Therapeutic inertia in type 2 diabetes: prevalence, causes, consequences and methods to overcome inertia

Ther Adv Endocrinol Metab. 2019 May 3:10:2042018819844694. doi: 10.1177/2042018819844694. eCollection 2019.

Abstract

Early glycaemic control leads to better outcomes, including a reduction in long-term macrovascular and microvascular complications. Despite good-quality evidence, glycaemic control has been shown to be inadequate globally. Therapeutic inertia has been shown present in all stages of treatment intensification, from the first oral antihyperglycaemic drug (OAD), all the way to the initiation of insulin. The causes and possible solutions to the problem of therapeutic inertia are complex but can be understood better when viewed from the perspective of the providers [healthcare professionals (HCPs)], patients and healthcare systems. In this review, we will discuss the possible aetiologies, consequences and solutions of therapeutic inertia, drawing upon evidence from published literature on the subject of type 2 diabetes.

Keywords: Therapeutic inertia; causes; insulin; oral antihyperglycaemic drugs; patient level; prevalence; providers; system level; type 2 diabetes.

Publication types

  • Review