Intensifying approaches to address clinical inertia among cardiovascular disease risk factors: A narrative review.

dc.contributor.author

Lewinski, Allison A

dc.contributor.author

Jazowski, Shelley A

dc.contributor.author

Goldstein, Karen M

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Whitney, Colette

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Bosworth, Hayden B

dc.contributor.author

Zullig, Leah L

dc.date.accessioned

2023-11-12T17:35:32Z

dc.date.available

2023-11-12T17:35:32Z

dc.date.issued

2022-12

dc.date.updated

2023-11-12T17:35:31Z

dc.description.abstract

Objective

Clinical inertia, the absence of treatment initiation or intensification for patients not achieving evidence-based therapeutic goals, is a primary contributor to poor clinical outcomes. Effectively combating clinical inertia requires coordinated action on the part of multiple representatives including patients, clinicians, health systems, and the pharmaceutical industry. Despite intervention attempts by these representatives, barriers to overcoming clinical inertia in cardiovascular disease (CVD) risk factor control remain.

Methods

We conducted a narrative literature review to identify individual-level and multifactorial interventions that have been successful in addressing clinical inertia.

Results

Effective interventions included dynamic forms of patient and clinician education, monitoring of real-time patient data to facilitate shared decision-making, or a combination of these approaches. Based on findings, we describe three possible multi-level approaches to counter clinical inertia - a collaborative approach to clinician training, use of a population health manager, and use of electronic monitoring and reminder devices.

Conclusion

To reduce clinical inertia and achieve optimal CVD risk factor control, interventions should consider the role of multiple representatives, be feasible for implementation in healthcare systems, and be flexible for an individual patient's adherence needs.

Practice implications

Representatives (e.g., patients, clinicians, health systems, and the pharmaceutical industry) could consider approaches to identify and monitor non-adherence to address clinical inertia.
dc.identifier

S0738-3991(22)00347-0

dc.identifier.issn

0738-3991

dc.identifier.issn

1873-5134

dc.identifier.uri

https://hdl.handle.net/10161/29372

dc.language

eng

dc.publisher

Elsevier BV

dc.relation.ispartof

Patient education and counseling

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10.1016/j.pec.2022.08.005

dc.subject

Humans

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Cardiovascular Diseases

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Cognition

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Educational Status

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Medical Assistance

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Heart Disease Risk Factors

dc.title

Intensifying approaches to address clinical inertia among cardiovascular disease risk factors: A narrative review.

dc.type

Journal article

duke.contributor.orcid

Lewinski, Allison A|0000-0002-1356-1857

duke.contributor.orcid

Goldstein, Karen M|0000-0003-4419-5869

duke.contributor.orcid

Bosworth, Hayden B|0000-0001-6188-9825

duke.contributor.orcid

Zullig, Leah L|0000-0002-6638-409X

pubs.begin-page

3381

pubs.end-page

3388

pubs.issue

12

pubs.organisational-group

Duke

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School of Medicine

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School of Nursing

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Medicine

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Psychiatry & Behavioral Sciences

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Medicine, General Internal Medicine

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Duke Cancer Institute

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Duke Clinical Research Institute

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Institutes and Provost's Academic Units

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Center for the Study of Aging and Human Development

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Initiatives

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Duke Science & Society

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Population Health Sciences

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Duke Innovation & Entrepreneurship

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Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

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Duke - Margolis Center For Health Policy

pubs.publication-status

Published

pubs.volume

105

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