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JAMA
Article . 2011 . Peer-reviewed
Data sources: Crossref
JAMA
Article . 2011
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Clinical Inertia as a Clinical Safeguard

Authors: GIUGLIANO, Dario; ESPOSITO, Katherine;

Clinical Inertia as a Clinical Safeguard

Abstract

INERTIA IS THE RESISTANCE OF A PHYSICAL OBJECT TO A change in its state of motion or rest. Phillips et al have described clinical inertia as “failure of health care providers to initiate or intensify therapy when indicated.” Although clinical inertia may apply to all medical fields, given the lag time between advances in clinical understanding and incorporation into clinical guidelines, as well as the other time needed for the translation of clinical guidelines into clinical practice, Phillips et al intended to limit the discussion of inertia to disorders in which abnormal values may be the only manifestation of the disease, such as diabetes, hypertension, and dyslipidemia. Main causes of clinical inertia include overestimation of care provided, use of “soft” reasons to avoid intensification of therapy (incorrect perception of clinical improvement, dietary nonadherence, and concerns about translation of clinical trials results to individual patients), and lack of understanding about achieving therapeutic goals. While physicians may cite patient refusal or nonadherence as the reason for clinical inertia, it seems likely that in many instances, physician inertia is the reason for the problem. Why physicians—who may have knowledge of and may be familiar with standard-of-care guidelines—seem to be subject to clinical inertia is still an open question. However, there may be an alternative interpretation for the phenomenon: clinical inertia may be a clinical safeguard for the drugintensive style of medicine fueled by the current medical literature.

Country
Italy
Keywords

Glycated Hemoglobin, Decision Making, Hypertension, Practice Guidelines as Topic, Diabetes Mellitus, Humans, Patient Care, Diffusion of Innovation, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Dyslipidemias

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    influence
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Powered by OpenAIRE graph
Found an issue? Give us feedback
selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
80
Top 10%
Top 10%
Top 1%
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