Intensifying approaches to address clinical inertia among cardiovascular disease risk factors: A narrative review

Lewinski, AA (通讯作者),Durham Vet Affairs Hlth Care Syst, Attn HSR &D COIN 558-152,508 Fulton St, Durham, NC 27705 USA.
2022-12
Objective: Clinical inertia, the absence of treatment initiation or intensification for patients not achieving evidence-based therapeutic goals, is a primary contributor to poor clinical outcomes. Effectively combating clinical inertia requires coordinated action on the part of multiple representatives including patients, clinicians, health systems, and the pharmaceutical industry. Despite intervention attempts by these representatives, barriers to overcoming clinical inertia in cardiovascular disease (CVD) risk factor control remain. Methods: We conducted a narrative literature review to identify individual-level and multifactorial interventions that have been successful in addressing clinical inertia.Results: Effective interventions included dynamic forms of patient and clinician education, monitoring of real-time patient data to facilitate shared decision-making, or a combination of these approaches. Based on find-ings, we describe three possible multi-level approaches to counter clinical inertia - a collaborative approach to clinician training, use of a population health manager, and use of electronic monitoring and reminder devices.Conclusion: To reduce clinical inertia and achieve optimal CVD risk factor control, interventions should consider the role of multiple representatives, be feasible for implementation in healthcare systems, and be flexible for an individual patient's adherence needs. Practice Implications: Representatives (e.g., patients, clinicians, health systems, and the pharmaceutical industry) could consider approaches to identify and monitor non-adherence to address clinical inertia.
PATIENT EDUCATION AND COUNSELING
卷号:105|期号:12|页码:3381-3388
ISSN:0738-3991|收录类别:SCIE
语种
英语
来源机构
Duke University; University of North Carolina; University of North Carolina Chapel Hill; Duke University; Vanderbilt University; Duke University; Oregon Health & Science University; Duke University
资助信息
The research reported in this publication was supported by Durham Center of Innovation to Accelerate Discovery and Practice Trans-formation grant #CIN 13-410 (to: AAL, HBB, LLZ, KMG) ; VA HSR & D grants #18-234 (to AAL) and #08-027 (to HBB) ; and the Agency for Healthcare Research and Quality grant #T32 HS026122 (to SAJ) . The content is solely the responsibility of the authors and does not reflect the position or policy of Duke University, the U.S. Department of Veterans Affairs, Agency for Healthcare Research and Quality, or the U.S. government.
被引频次(WOS)
0
被引频次(其他)
0
180天使用计数
1
2013以来使用计数
1
EISSN
1873-5134
出版年
2022-12
DOI
10.1016/j.pec.2022.08.005
关键词
Clinical inertia Disease management Medication adherence Treatment outcome Diabetes mellitus Cardiovascular disease
资助机构
Durham Center of Innovation VA HSRD Agency for Healthcare Research and Quality(United States Department of Health & Human ServicesAgency for Healthcare Research & Quality)
WOS学科分类
Public, Environmental & Occupational Health Social Sciences, Interdisciplinary
学科领域
循证公共卫生 循证社会科学-综合