Effect of Therapeutic Inertia on Treatment Outcomes in Type 2 Diabetes Patients at a Tertiary Care Hospital in Southern Ethiopia: A retrospective Cohort Study

Abstract

Abstract Aims Therapeutic inertia is the failure to initiate or intensify treatment when clinically indicated, remains a major challenge to optimal glycemic control in patients with type 2 diabetes. This retrospective cohort study investigated the effect of therapeutic inertia on treatment outcomes in patients with type 2 diabetes receiving care at a tertiary hospital in southern Ethiopia. Materials and methods A retrospective cohort study was conducted among 159 adult ambulatory type 2 diabetic patients between June 2020-2023. We collected the data from medical records and we used EpiData version 4.6 for data entry and SPSS version 25 for analysis. The independent sample t-test, fisher’s exact test and chi-square test were used for data analysis as appropriate. To assess the effect of therapeutic inertia on diabetic treatment outcomes, we applied a cox proportional hazard model. A p-value of less than 0.05 was considered statistically significant. Results In this study, we reviewed the medical records of type 2 diabetic patients. Poor treatment outcomes were common in exposed to therapeutic inertia group (68.63%).There was a statistically significant difference between groups in the type of physician managing the patients (p=0.01).furthermore, the presence of comorbidity (p=0.024), mean fasting plasma glucose level (p=0.01), neuropathy(p=0.02) and nephropathy (p=0.011) showed a significant association with therapeutic inertia. Therapeutic inertia exposed group was significantly associated with increased the risk of poor treatment outcome with adjusted HR of 1.927 (95% CI: 1.201-3.092, p = 0.007). Conclusions Our study showed therapeutic inertia has worsened diabetic treatment outcomes among type 2 diabetes patients. This underlines the Healthcare providers should prioritize proactive management, such as regular reassessment of treatment efficacy and prompt adjustment of therapies, to improve patient outcomes.