นโยบายงานวิจัย /จรรยาบรรณนักวิจัย /ระดับคุณภาพบทความวิจัยตีพิมพ์ /ระดับคุณภาพผลงานวิชาการ /แหล่งทุน /ดาวน์โหลด /ฐานข้อมูลวิจัย /วิเคราะห์-สังเคราะห์งานวิจัย /ลิขสิทธิ์ /ข่าว


Clinical Inertia in Type2 Diabetic Patients in Community Hospitals in Ubon Ratchathani


Author

-

Likhit Pholdee, Phisitt Vejakama, Nonglek Kunawaradisai, Sawaeng Watcharathanakij


Journal

- TJPP

Volume

- 12

Year

- 2020

Publication type

- Research article (National)

Page list

- 1

Abstract

   
Objectives
:
To measure time from treatment initiation to clinical inertia in patients with type2 diabetes treated
with oral antidiabetic agents identified by comparing with the Clinical Practice Guideline of Diabetes and to identify
factors associated with clinical in
ertia.
Methods:
This retrospective cohort study used electronic medical records of
newly diagnosed type 2 diabetes patients who received medical services in 16 community hospitals in Ubon
Ratchathani from June 1, 2008 through December 31, 2015. The prima
ry data were fasting blood sugar and types of
oral antidiabetic agents received on the day of hospital visits, which were examined to identify diabetic patients with
clinical inertia. Those with clinical inertia were the patients receiving no treatment int
ensification when the treatment
goal was not achieved according to Clinical Practice Guidelines for Diabetes in 2008, 2011 and 2015, Identification of
factors associated with clinical inertia was conducted using logistic regression analysis.
Results:
Of 15
,433 eligible
patients, 5,410 (35.05%) patients had clinical inertia. The average time to first clinical inertia in patients receiving
medical services during June 1, 2008 through December 31, 2010 (phase 1), January 1, 2011 through December 31,
2013 (pha
se 2) and January 1, 2014 through December 31, 2015 (phase 3) were 377.7 ± 5.46, 348.75 ± 3.39
and
316.75 ± 3.62 days respectively. The proportion of patients with at least one clinical inertia was 19.35%, 32.61% and
42.73% in phase 1 to phase 3 respectiv
ely. Statistically significant factors associated with lower clinical inertia were
patients aged
55
62
years
(
OR = 0.75; 95
%
CI =
0.60
0.94
)
, and aged
63 years
(
OR = 0.67; 95
%
CI =
0.54
0.83
)
, being female
(
OR = 0.84; 95
%
CI =
0.73
0.98), patients wit
h hypertension
(
OR = 0.85; 95
%
CI =
0.59
0.81
)
,
patients receiving medical service at two hospitals
(
OR = 0
.
14; 95
%
CI =
0.04
0.50, OR = 0.52; 95
%
CI = 0.35
0.79
).
Conclusion
:
Clinical inertia was observed more frequently and with shorter time from pha
se 1 to phase 3.
Approximately one third of type 2 diabetic patients had clinical inertia. Patients with older age, being female, having
hypertension, and receiving care from 2 community hospitals were less likely to have clinical inertia than the others


(PDF) Clinical Inertia in Type2 Diabetic Patients in Community Hospitals in Ubon Ratchathani. Available from: https://www.researchgate.net/publication/331952414_Clinical_Inertia_in_Type2_Diabetic_Patients_in_Community_Hospitals_in_Ubon_Ratchathani [accessed Mar 29 2019].


Keywords

   

clinical inertia, type 2 diabetes, antidiabetic medications