title: Physician and patient characteristics associated with clinical inertia in blood pressure control.
abstract: Clinical inertia, the failure to adjust antihypertensive medications during patient visits with uncontrolled hypertension, is thought to be a common problem. This retrospective study used 5 years of electronic medical records from a multispecialty group practice to examine the association between physician and patient characteristics and clinical inertia. Hierarchical linear models (HLMs) were used to examine (1) differences in physician and patient characteristics among patients with and without clinical inertia, and (2) the association between clinical inertia and future uncontrolled hypertension. Overall, 66% of patients experienced clinical inertia. Clinical inertia was associated with one physician characteristic, patient volume (odds ratio [OR]=0.998). However, clinical inertia was associated with multiple patient characteristics, including patient age (OR=1.021), commercial insurance (OR=0.804), and obesity (OR=1.805). Finally, patients with clinical inertia had 2.9 times the odds of uncontrolled hypertension at their final visit in the study period. These findings may aid the design of interventions to reduce clinical inertia.
authors.affiliation: Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Harle
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Harman
authors.forename: Shuo
authors.initials: S
authors.lastname: Yang
mesh_terms: D000367:Age Factors; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007348:Insurance, Health; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity; D010045:Outpatients / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents