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

• Published in: Medical science monitor Vol. 24; pp. 8141 - 8149
• Main Authors: Marjanović, Marijan, Vrdoljak, Davorka, Bralić Lang, Valerija, Polašek, Ozren, Đido, Vedran, Kašćel Fišić, Marinka, Mađar Šimić, Ivanka, Dodig, Danijela, Radoš Perić, Marina
• Format: Journal Article
• Language: English
• Published: United States International Scientific Literature, Inc 13-11-2018
• Subjects: Adult; Aged; Blood Glucose - analysis; Blood Glucose - metabolism; Bosnia and Herzegovina - epidemiology; Clinical Research; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - therapy; Family Practice - statistics & numerical data; Female; General Practitioners - statistics & numerical data; Glycated Hemoglobin A - metabolism; Humans; Male; Middle Aged; Physicians, Family; Practice Patterns, Physicians' - statistics & numerical data; Primary Health Care - statistics & numerical data; Surveys and Questionnaires; Treatment Outcome; Bosnia and Herzegovina
• ISSN: 1643-3750; 1234-1010; 1643-3750
• 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.