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# Therapeutic inertia

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 Title: Therapeutic inertia Author: World Heritage Encyclopedia Language: English Subject: Collection: Publisher: World Heritage Encyclopedia Publication Date:

### Therapeutic inertia

Therapeutic inertia (also known as clinical inertia) is a measurement of the resistance to therapeutic treatment for an existing medical condition. It is commonly measured as a percentage of the number of encounters in which a patient with a condition received new or increased therapeutic treatment out of the total number of visits to a health care professional by the patient. A high percentage indicates that the health care provider is slow to treat a medical condition. A low percentage indicates that a provider is extremely quick in prescribing new treatment at the onset of any medical condition.

## Calculation

There are two common methods used in calculating therapeutic inertia. For the following examples, consider that a patient has five visits with a health provider. In four of those visits, a condition is not controlled (such as high blood pressure or high cholesterol). In two of those visits, the provider made a change to the patient's treatment for the condition.

In Dr. Okonofua's original paper, this patient's therapeutic inertia is calculated as $\frac\left\{h\right\}\left\{v\right\} - \frac\left\{c\right\}\left\{v\right\}$ where h is the number of visits with an uncontrolled condition, c is the number of visits in which a change was made, and v is the total number of visits.[1] Therefore, the patient's therapeutic inertia is $\frac\left\{4\right\}\left\{5\right\} - \frac\left\{2\right\}\left\{5\right\} = 0.4 = 40%$.

An alternative, which avoids consideration of visits where the condition was already controlled and the provider should not be expected to make a treatment change, is $1 - \frac\left\{c\right\}\left\{h\right\}$. Using the above example, there are 2 changes and 4 visits with an uncontrolled condition. The therapeutic inertia is $1 - \frac\left\{2\right\}\left\{4\right\} = 0.5 = 50%$.

## Reception

Therapeutic inertia was devised as a metric for measuring treatment of hypertension. It has now become a standard metric for analysing treatment of common comorbidities such as diabetes[2] and hyperlipidemia.[3] Healthcare feedback reporting processes and intervention studies focused on therapeutic inertia reduction have been shown to increase control of hypertension (as well as diabetes and hyperlipidemia).[4]