Open AccessPhysician and Patient Characteristics Associated With Clinical Inertia in Blood Pressure Control
Author(s) -
Harle Christopher A.,
Harman Jeffrey S.,
Yang Shuo
Publication year - 2013
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.12179
Subject(s) - medicine , odds , medical record , odds ratio , inertia , retrospective cohort study , physical therapy , logistic regression , physics , classical mechanics
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.