title: [INERTIA study: Clinical inertia in non-insulinized patients on oral hypoglycemic treatment. A study in Spanish primary and specialty care settings].
abstract: OBJECTIVE
  To study clinical inertia in the management of oral hypoglycemic agents (OHA) in non-insulin treated patients with type 2 diabetes mellitus (T2DM) in Spain.
  
  
  METHODS
  Epidemiological, cross-sectional, retrospective (2 years), multicenter study. Clinical inertia was measured as the total number of patients without OHA treatment intensification divided by the total number of patients with inadequate HbA1c values (≥7%), multiplied by 100. Total clinical inertia (TCI) was the absence of OHA treatment intensification in all visits with a HbA1c≥7% values in the previous 2 years; partial clinical inertia (PCI) occurred when this absence only occurred in some of these visits. We assessed OHA treatment compliance with the Morisky-Green test.
  
  
  RESULTS
  We included 2,971 patients, 1,416 adequately controlled (HbA1c<7%) and 1,555 inadequately controlled (HbA1c≥7%). PCI prevalence was 52.5%(95% confidence interval [95% CI] 52.4-52.6%) while TCI prevalence was 12.8% (95% CI 12.2-13.8%). PCI was lower in patients adequately controlled as compared with those inadequately controlled (31.4% vs. 71.8%; P<.001). PCI was associated with sedentary lifestyle, hypertension and higher prevalence of micro and macrovascular complications. Only 38.0% of patients were compliant with the OHA treatment, being this percentage even lower in subjects with ICP. Two variables were independently associated with ICP: female sex (odds ratio [OR] 1.43; 95% CI 1.09-1.86%) and a shorter duration of DM2 (OR 0.98; 95% CI 0.95-0.99).
  
  
  CONCLUSIONS
  One out of 2 patients with T2DM and treated with OHA without insulin suffer from PCI. Only 4 out of 10 patients are compliant with OHA treatment. Female sex and a shorter duration of T2DM are independently associated with PCI.
authors.affiliation: Servicio de Diabetes, Endocrinología y Nutrición, Hospital de Sabadell, Corporación Sanitaria Parc Taulí, Instituto Universitario Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España. Electronic address: jmgonzalez@tauli.cat.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: González-Clemente
authors.affiliation: Novartis Farmacéutica S. A., Barcelona, España.
authors.forename: Beatriu
authors.initials: B
authors.lastname: Font
authors.affiliation: Novartis Farmacéutica S. A., Barcelona, España.
authors.forename: Raquel
authors.initials: R
authors.lastname: Lahoz
authors.affiliation: Servicio de Diabetes, Endocrinología y Nutrición, Hospital de Sabadell, Corporación Sanitaria Parc Taulí, Instituto Universitario Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España.
authors.forename: Gemma
authors.initials: G
authors.lastname: Llauradó
authors.affiliation: Novartis Farmacéutica S. A., Barcelona, España.
authors.forename: Gemma
authors.initials: G
authors.lastname: Gambús
mesh_terms: D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D008511:Medicine; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
keywords: Clinical inertia; Diabetes tipo 2; Glycosylated haemoglobin; Hemoglobina glucosilada; Inercia clínica; Morisky-Green test; Test de Morisky-Green; Type 2 diabetes