Gabbay Robert A, Kendall Debbie, Beebe Christine, Cuddeback John, Hobbs Todd, Khan Naeem D, Leal Sandra, Miller Eden, Novak Lucia M, Rajpathak Swapnil N, Scribner Paul, Meneghini Luigi, Khunti Kamlesh
American Diabetes Association, Arlington, VA.
Kendall Editorial, Richmond, VA.
Clin Diabetes. 2020 Oct;38(4):371-381. doi: 10.2337/cd20-0053.
Research has shown that getting to glycemic targets early on leads to better outcomes in people with type 2 diabetes; yet, there has been no improvement in the attainment of A1C targets in the past decade. One reason is therapeutic inertia: the lack of timely adjustment to the treatment regimen when a person's therapeutic targets are not met. This article describes the scope and priorities of the American Diabetes Association's 3-year Overcoming Therapeutic Inertia Initiative. Its planned activities include publishing a systematic review and meta-analysis of approaches to reducing therapeutic inertia, developing a registry of effective strategies, launching clinician awareness and education campaigns, leveraging electronic health record and clinical decision-support tools, influencing payer policies, and potentially executing pragmatic research to test promising interventions.
研究表明,早期实现血糖目标可使2型糖尿病患者获得更好的治疗效果;然而,在过去十年中,糖化血红蛋白(A1C)目标的达成情况并无改善。原因之一是治疗惰性:当患者未达到治疗目标时,未能及时调整治疗方案。本文介绍了美国糖尿病协会为期三年的克服治疗惰性倡议的范围和重点。其计划开展的活动包括发表关于减少治疗惰性方法的系统评价和荟萃分析、建立有效策略登记册、开展临床医生意识和教育活动、利用电子健康记录和临床决策支持工具、影响医保支付方政策,以及可能开展务实研究以测试有前景的干预措施。