Examining therapeutic inertia patterns in type 2 diabetes patients with multiple chronic conditions: Time-to-event analysis.
Objective: Therapeutic inertia (TI) in type 2 diabetes (T2D)—delayed treatment adjustment despite elevated A1C—is often complicated by multiple chronic conditions (MCC). We examined how clinicians address TI in patients with T2D and MCC and evaluated association with patient, clinic, and neighborhoo...
| Publicado en: | Journal of Multimorbidity & Comorbidity Vol. 16; pp. 1 - 14 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
8/22/2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=196384243&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 196384243 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 26335565 N4V2 jtl: Journal of Multimorbidity & Comorbidity issn: 26335565 maglogo: Y pubinfo: dt: 8/22/2026 vid: 16 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 196384243 196384243 196384243 10.1177/26335565261469776 196384243 ppf: 1 ppct: 13 formats: tig: atl: Examining therapeutic inertia patterns in type 2 diabetes patients with multiple chronic conditions: Time-to-event analysis. aug: au: Chen, Helen Chung, Lap Pui Balius, Patrick Budhkar, Aishwarya Shishir Punater, Paras Fu, Mark Schleyer, Titus Sang, Elaine Nkrumah, Isaac Wolfson, Julian affil: Divison of Nursing Science, School of Nursing, Rutgers University, New Brunswick, NJ, USA sug: subj: Diabetes Mellitus, Type 2 Drug Therapy Chronic Disease Comorbidity Glycated Hemoglobin Blood Treatment Delay Practice Patterns Human Funding Source United States Male Female Adult Middle Age Aged Aged, 80 and Over Retrospective Design Record Review Nonexperimental Studies Prospective Studies Descriptive Statistics Kaplan-Meier Estimator Log-Rank Test Cox Proportional Hazards Model Data Analysis Software Diabetic Patients Healthcare Disparities Drugs, Prescription Residence Characteristics Neighborhood Characteristics Insulin Therapeutic Use Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Objective: Therapeutic inertia (TI) in type 2 diabetes (T2D)—delayed treatment adjustment despite elevated A1C—is often complicated by multiple chronic conditions (MCC). We examined how clinicians address TI in patients with T2D and MCC and evaluated association with patient, clinic, and neighborhood factors. Methods: Using electronic health records from two Midwestern U.S. health systems, we identified a retrospective six-year cohort of adults with T2D, MCC, and above-target A1C (>7% [53 mmol/mol] for age < 65; >8% [64 mmol/mol] for age ≥ 65). Time-to-event analyses assessed factors associated with clinicians addressing TI. The event was defined as maintaining TI ≤ 0.5 for two consecutive years indicating prescription changes occurred in more than 50% of opportunities following above-target A1C. Covariates included demographics, comorbidity, insulin use, number of diabetes drug classes, clinic rurality, and neighborhood social deprivation. Findings: A cohort of 18,003 adults met eligibility criteria (mean age 59; 78% White). Among patients with T2D and MCC, clinicians addressed TI in 17% of cases at two-year, 31% at four-year, and 38% at five-year follow-up. Clinicians were more likely to address TI with MCC in patients experiencing greater social deprivation and being prescribed with more diabetes drug classes at baseline (p <0.05). Despite addressing TI, patients aged 18–44 had the worst glycemic control (8.3% [67 mmol/mol]) and high prevalence of depression (82%). Conclusion: Therapeutic inertia varied by patient, clinic, and neighborhood factors, emphasizing the need for targeted, multifaceted interventions to reduce TI, especially among populations facing socioeconomic and mental health challenges. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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