Background
The burden of uncontrolled hypertension
Clinical and therapeutic inertia
Methods
Types of studies considered for the review
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Trials
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Surveys and epidemiological studies
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Qualitative research
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Reviews
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Opinion papers and editorials about the concept of inertia or about guideline-implementation issues
Search strategy for identification of studies
Databases
Additional searches
Methods of the review
Abstracts selection
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The words “clinical inertia” or “therapeutic inertia” appeared
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Hypertension guidelines implementation was the main subject
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Design, assessment, or evaluation of any kind of intervention directed to the general practitioner for hypertension control was the main topic
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The general practitioners’ behaviors or barriers to change regarding hypertension treatment were the main topic.
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Although these last topics were not part of the research question, chances were that the concept of therapeutic inertia would be discussed in such articles.
Full-texts assessment
Process of data collection
Results
Search results
Types of publications and their contents
Coding
Terms and definitions
Term | First occurrence | Definition |
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Clinical inertia | Phillips et al.. Ann Intern Med 2001,135:825–834. |
Health care providers often do not initiate or intensify therapy appropriately during visits of patients with these problems [hypertension, dyslipidemia and diabetes]. We define such behavior as clinical inertia—recognition of the problem, but failure to act.
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Therapeutic inertia | Okonufa et al.. Hypertension 2006,3:345–351. |
Therapeutic inertia (TI), that is, failure of providers to begin new medications or increase dosages of existing medications when an abnormal clinical parameter is recorded.
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Patient's inertia | Vinyoles. Hipertension 2007,24:91–92. |
Three inertias are barriers to change: physician's inertia, patient's inertia, and health authorities inertia.
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(Translated from Spanish) | ||
Health authorities inertia | Vinyoles. Hipertension 2007,24:91–92. |
Three inertias are barriers to change: physician's inertia, patient's inertia, and health authorities inertia.
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(Translated from Spanish) | ||
Physician inertia | Vinyoles. Hipertension 2007,24:91–92. |
Three inertias are barriers to change: physician's inertia, patient's inertia, and health authorities inertia.
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(Translated from Spanish) | ||
Moser et al.. J Clin Hypertens 2009,11:1–4. |
Physician inertia is defined as the failure to initiate therapy or to intensify or change therapy in patients with BP values >140 ⁄90 mmHg, or >130⁄80 mm Hg in hypertensive patients with diabetes, renal, or coronary heart disease.
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Clinical Myopia | Reach. Diabetes Metab 2008,34:382–385. |
We suggest that a failure to give preference to the long-term benefits of treatment intensification may represent a common mechanism underlying both patient non-adherence and physician clinical inertia. We dub such a failure as “clinical myopia”.
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Therapeutic momentum | Faria et al.. J Am Soc Hypertens 2009,3:267–276. |
Therapeutic inertia, therapeutic momentum, and physician inertia are all terms synonymous with clinical inertia
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Rodrigo et al.. Int J Clin Pract 2013,67:97–98. |
The reluctance to step down or withdraw therapy when further prescription is not needed or not supported by evidence. We have termed it ‘therapeutic momentum’.
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Diagnostic inertia | Gil-Guillén et al.. Blood Press 2010,19:3–10. |
Diagnostic inertia was defined as a failure to consider the diagnosis of HTN in a subject in the absence of diagnosis of HTN and elevated BP.
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