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Clinical Inertia in Type 2 Diabetes Patients in Primary Health Care Clinics in Central Bosnia

Marijan Marjanović, Davorka Vrdoljak, Valerija Bralić Lang, Ozren Polašek, Vedran Đido, Marinka Kašćel Fišić, Ivanka Mađar Šimić, Danijela Dodig, Marina Radoš Perić

(Faculty of Health Care, University “Vitez”, Vitez, Bosnia and Herzegovina)

Med Sci Monit 2018; 24:8141-8149

DOI: 10.12659/MSM.911286

BACKGROUND: The goal of this research was to determine the frequency of clinical inertia of general practice physicians in the region of Central Bosnia in healthcare for type 2 diabetes patients, to analyze characteristics of patients and physicians, as well as glucose regulation during clinical inertia, and, on the basis of these indicators, give recommendations for reducing clinical inertia.
MATERIAL AND METHODS: This study included 29 doctors, family physicians, or general practitioners, who collected data in a total sample of 541 type 2 diabetes mellitus patients from July to November 2017. The research was conducted using 2 questionnaires. The glucose concentration in plasma and the percentage of glycosylated hemoglobin (HbA1c) were determined. Concertation of cholesterol, triglycerides, AST, and ALT were also measured. After the collection, new data were processed and the degree of clinical inertia was determined.
RESULTS: Levels of HbA1c ranged from 4.3% to 13.0%, and 38.4% of all patients had HbA1c level higher than 7.5%, while 8.3% of them had HbA1c level 9.0% or higher. Clinical inertia in our research was 12.6% out of all patients and 48.2% were referred to a specialist by their doctor.
CONCLUSIONS: For better regulation of glycemia and reduction of clinical inertia with type 2 diabetes patients, more specialized training is needed for selected physicians. Strengthening of primary healthcare and encouraging doctors to perform procedures can contribute to better outcomes of treatment, lower clinical inertia, and better education of patients.

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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