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

Journal

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/2042018819844694

Keywords

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

Funding

  1. National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC), East Midlands
  2. NIHR Leicester Lifestyle Biomedical Research Unit

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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.

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