title: Interventions to reduce clinical inertia in cardiac risk factor management in renal transplant recipients.
abstract: Cardiovascular disease (CVD) is the leading cause of death in renal transplant recipients (RTRs). Clinical inertia (CI) is defined as "recognition of the problem, but failure to act." The effect of educational interventions in minimizing CI in CVD risk factor management was assessed. Educational sessions were conducted among 201 RTRs to inform them about their goals for blood pressure (BP), low-density lipoprotein cholesterol (LDL-C) and glycated hemoglobin (HbA1c). Physicians were reminded about treatment goals using checklists. Pre-intervention and post-intervention CI was measured as "no action" or "appropriate action" by the physicians. Post-intervention percentage of RTRs with "no clinical action" for BP, LDL-C, and HbA1c control decreased from 10.8% to 3.8% (P=.02), 28.2% to 11.1% (P=.008), and 10.3% to 4.5% (P=.05), respectively, while those with "appropriate action" increased from 66.2% to 83.3% (P<.001), 68.7% to 79.4% (P=.008), and 85.1% to 93.2% (P=.03), respectively. Educational interventions and patient participation were shown to reduce CI.
authors.affiliation: Department of Internal Medicine, Buffalo, NY.
authors.forename: Dhanashri D
authors.initials: DD
authors.lastname: Kohok
authors.forename: Silvi
authors.initials: S
authors.lastname: Shah
authors.forename: Rakesh
authors.initials: R
authors.lastname: Kumar
authors.forename: Lisa
authors.initials: L
authors.lastname: Venuto
authors.forename: Gregory
authors.initials: G
authors.lastname: Gudleski
authors.forename: Rocco
authors.initials: R
authors.lastname: Venuto
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000628:therapy*; D057189:Checklist; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000628:therapy; D050171:Dyslipidemias / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000628:therapy; D016030:Kidney Transplantation / Q000401:mortality; D010353:Patient Education as Topic; D011182:Postoperative Care; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D012307:Risk Factors