2024, Number 2
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Aten Fam 2024; 31 (2)
Therapeutic Inertia in Patients with Uncontrolled Type 2 Diabetes Mellitus
Suastegui-Hernández LF, Vargas-Aragón R, Lagarza- Moreno AJ, Rodríguez-Jaimes A, Joanico-Morales B, Suástegui-Hernández JJ, Sánchez-Vicente É, Sosa-Martínez MJ
Language: Spanish
References: 28
Page: 75-81
PDF size: 175.86 Kb.
ABSTRACT
Objective: to analyze therapeutic inertia
in patients with uncontrolled type 2
diabetes mellitus in a Family Medicine
unit.
Methods: analytical cross-sectional
study conducted in a Family Medicine
unit in Acapulco, Mexico. 255 records of
uncontrolled patients with a diagnosis of
type 2 diabetes mellitus were included, by
non-probabilistic convenience sampling,
from January to February 2023. The
source of information was the medical
record and laboratory database to obtain
sociodemographic, clinical, anthropometric,
and biochemical information.
Medical records were reviewed to assess
whether the physician changed the
pharmacological treatment after the laboratory
results. The seniority and training
of the physician were obtained from the
Coordination of Health Education and
Research. Descriptive statistics, bivariate
analysis by Mantel-Haenszel χ
2, and
logistic regression were performed on the
data obtained. A value of p‹0.05 and 95%
CI was considered statistically significant.
Results: the incidence of therapeutic
inertia (TI) was 85.9% (n= 219), 67.8%
(n= 173) of the medical staff attended at
least one face-to-face or online training
course on diabetes mellitus. Being ‹60
years of age (ORA 2.99, 95% CI 1.40-6.39,
p 0.002) increased the likelihood of therapeutic
inertia.
Conclusion: Eight out of
ten patients with uncontrolled diabetes
mellitus presented therapeutic inertia. It
is important to raise awareness and promote
an integral approach in which the
patient, physician, and institution actively
participate, and synergistically to achieve
adequate metabolic control.
REFERENCES
Instituto Mexicano del Seguro Social. Diagnósticoy tratamiento farmacológico de la Diabetes MellitusTipo 2 en el Primer Nivel de Atención. Guía deEvidencias y Recomendaciones: Guía de PrácticaClínica. México, IMSS; 2018.
Velasco-Contreras ME. Evolution of the type2 diabetes mellitus epidemic in insured populationat the IMSS. Rev Med Inst Mex Seg Soc.2016;54(4):490- 503.
Federación Internacional de Diabetes. Atlas de laFederación Internacional de Diabetes. Décima edición.2021.
Villalpando S, de la Cruz V, Rojas R, Shamah-LevyT, Avila MA, Gaona B, et al. Prevalence and distributionof type 2 diabetes mellitus in Mexican adultpopulation: a probabilistic survey. Salud PublicaMex. 2010;52(1):19-26.
Basto-Abreu A, López-Olmedo N, Rojas-MartínezR, Aguilar-Salinas CA, Moreno-Banda GL, CarnallaM, et al. Prevalencia de prediabetes y diabetesen México: Ensanut 2022. Salud Publica Mex.2023;65(1):163-168.
Instituto Mexicano del Seguro Social. Diagnósticosituacional de prevención y control de enfermedades2019. 2019.
López-Simarro F. Inercia Terapéutica. Causas y soluciones.Hipertens riesgo vasc. 2012; 29:28-33.
Fundacion redGDPS. Suplemento extraordinariodiabetes práctica. Inercia terapéutica en el tratamientode la diabetes tipo 2. Fundación redGDPS.
García Morales G, Reyes Jiménez M. Inercia clínicaen pacientes con diabetes mellitus tipo 2 en unaunidad de medicina familiar de Acapulco Guerrero,México. Aten Fam. 2017;24(3):102-106.
Vázquez F, Lavielle P, Gómez-Díaz R, Wacher N.Inercia clínica en el tratamiento con insulina en elprimer nivel de atención. México. Gac Med Mex.2019; 155:161.
Flora López S. Inercia terapéutica en diabetes. DiabetesPráctica. 2014;05(02):49-96.
Martell CN, Franch J. Inercia e incumplimiento apartes iguales. Hipertens riesgo vasc. 2012;29(1):1-3.
Machado-Alba EJ. ¿Inercia clínica, que tanto nosafecta? Rev Med Risaralda. 2013;19(1):94-96.
Bralic-Lang V, Bergman-Markovic B, KranjcevicK. Family Physician Clinical Inertia in GlycemicControl among Patients with Type 2 Diabetes.Med Sci Monit. 2015; 21:403-411.
Strain WD, Bluher M, Paldanius P. Clinical Inertiain Individualising Care for Diabetes: Is There Timeto do More in Type 2 Diabetes? Diabetes Ther.2014; 5:347-354.
Lopez-Simarro F, Brotons C, Moral I, Cols-SagarraC, Selva A, Aguado-Jodar A, et al. Inertia andtreatment compliance in patiets with type 2 diabetesin primary care. Med Clin. 2012;138(9):377-84.
G. Reach, V. Pechtner, R. Gentilella, A Corcos,A Ceriello. Clinical inertia and its impact ontreatment intensification in people with type 2 diabetesmellitus. diabetes and metabolism. Elsevier.2017;43(6): 501-511.
National Cholesterol Education Program (NCEP)Expert Panel on Detection, Evaluation, andTreatment of High Blood Cholesterol in Adults(Adult Treatment Panel III). Third Report of theNational Cholesterol Education Program (NCEP)Expert Panel on Detection, Evaluation, andTreatment of High Blood Cholesterol in Adults(Adult Treatment Panel III) final report. Circulation.2002;106(25):3143-3421.
Instituto Mexicano del Seguro Social. Algoritmosterapéuticos para diabetes mellitus tipo 2. Materialde apoyo para el usuario. IMSS 2020.
Andersson N, Mitchell S. CIETmap: Free GIS andepidemiology software from the CIETgroup, helpingto build the community voice into planning.In World Congress of Epidemiology. Montreal,Canada, 2002.
Bello-Escamilla NV, Montoya-Cáceres PA. Adherenciaal tratamiento farmacológico en adultosmayores diabéticos tipo 2 y sus factores asociados.Gerokomos. 2017;28(2):73-77.
Mata-Cases M, Benito-Badorrey B, Roura-OlmedaP, Franch-Nadal J, Pepió-Vilaubí JM, Saez M, etal. Clinical inertia in the treatment of hyperglycemiain type 2 diabetes patients in primary care.Curr Med Res Opin. 2013;29(11):1495-14502.
Vernet-Vernet M, Sender-Palacios MJ, Bautista-Galí MJ, Larrosa-Saez P, Vargas-Sánchez J. Inerciaterapéutica en el manejo de pacientes con diabetesmellitus tipo 2 en el ámbito de la Atención Primaria.Semergen. 2016;42(3):152-157.
González-Clemente JM, Font B, Lahoz R, LlauradóG, Gambús G. Inercia clínica en pacientes con diabetesmellitus tipo 2 no insulinizados en tratamientocon hipoglucemiantes orales. Estudio INERCIA.Med Clin (Barc). 2014;142(11):478–484.
Hidalgo-Rodríguez A, Enguix DM, Aguirre-RodríguezJC, Sánchez-Cambronero M. Inercia terapéuticaen el control glucémico según objetivosindividualizados en una cohorte de pacientes condiabetes tipo 2: resultados del estudio COCARDIA2.Revista de Endocrinología y nutrición.2022;69(7):458-465.
Gomes da Silva-Gonçalves MJ, Fonseca C, PintalhaoI, Costa R, Henriques M. Diabetes mellitusnão controlada: inércia vs adesão à terapéutica. RevPort Med Geral Fam. 2023;39:22-28.
Cuevas-Fernández FJ, Pérez de-Armas A, Cerdeña-Rodríguez E, Hernández-Andreu M, Iglesias-GirónMJ, García-Marrero MR, et al. Mal control dela diabetes tipo 2 en un centro de salud de atenciónprimaria: factores modificables y población diana.Aten Primaria. 2021;53(9):102066.
Khunti K, Wolden M, Larsen TB, Andersen M, DaviesMJ. Clinical Inertia in People with type 2 diabetes:A retrospective cohort study of more than 80,000people. Diabetes Care. 2013;36(11):3411-3417.