Clinical inertia in insulin prescription for patients with type 2 diabetes mellitus among family physicians in Saudi Arabia.
To explore the knowledge and perceptions of primary care physicians about clinical inertia in the management of type 2 diabetes, and to identify the contributing factors.
The cross-sectional study was conducted in Madinah, Saudi Arabia between April and May 2020, and comprised qualified doctors working in primary care centres as general practitioners or board-certified family physicians. Data was collected using a questionnaire on participants' demographics, knowledge and practices related to diabetes management, and their perceptions regarding clinical inertia in the management of type 2 diabetes. The questionnaire was distributed online. Data was analysed using SPSS 28.
Of the 250 subjects approached, 200 (80%) completed the questionnaire; 105(52.5%) males and 95(47.5%) females. There were 78 (39%) subjects aged 41-50 years. Overall, 90(45%) subjects were general practitioners, 41(20.5%) were family medicine specialists, and 62(31%) were family medicine consultants. Of the total, 96(48%) respondents were aware of the concept of therapeutic inertia. Factors contributing to inertia were identified at the patient, physician and system levels. Physician-related factors included concern about hypoglycaemia 129(64.5%), complexity of treatment 111(55.5%), and patient refusal 67(33.5%). Patient-related barriers were resistance to lifestyle modifications 132 (66.0%), fear of weight gain 105(52.5%), and fear of injections 101(50.5%). System-level barriers included lack of multidisciplinary teams 137(68.5%), time constraints 107 (53.5%), and high workload 104(52.0%). A significant association was found between professional classification and awareness of therapeutic inertia (p<0.05).
Addressing barriers at the physician and system levels could help reduce clinical inertia in insulin prescription, potentially leading to improved diabetes outcomes.
The cross-sectional study was conducted in Madinah, Saudi Arabia between April and May 2020, and comprised qualified doctors working in primary care centres as general practitioners or board-certified family physicians. Data was collected using a questionnaire on participants' demographics, knowledge and practices related to diabetes management, and their perceptions regarding clinical inertia in the management of type 2 diabetes. The questionnaire was distributed online. Data was analysed using SPSS 28.
Of the 250 subjects approached, 200 (80%) completed the questionnaire; 105(52.5%) males and 95(47.5%) females. There were 78 (39%) subjects aged 41-50 years. Overall, 90(45%) subjects were general practitioners, 41(20.5%) were family medicine specialists, and 62(31%) were family medicine consultants. Of the total, 96(48%) respondents were aware of the concept of therapeutic inertia. Factors contributing to inertia were identified at the patient, physician and system levels. Physician-related factors included concern about hypoglycaemia 129(64.5%), complexity of treatment 111(55.5%), and patient refusal 67(33.5%). Patient-related barriers were resistance to lifestyle modifications 132 (66.0%), fear of weight gain 105(52.5%), and fear of injections 101(50.5%). System-level barriers included lack of multidisciplinary teams 137(68.5%), time constraints 107 (53.5%), and high workload 104(52.0%). A significant association was found between professional classification and awareness of therapeutic inertia (p<0.05).
Addressing barriers at the physician and system levels could help reduce clinical inertia in insulin prescription, potentially leading to improved diabetes outcomes.
Authors
Surrati Surrati, Alshanqiti Alshanqiti, Albadrani Albadrani, AlHarbi AlHarbi, Abu Baker Tobaiqi Abu Baker Tobaiqi
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