Department of Physiology, Pharmacology, and Toxicology, Faculty of Medicine and Health Sciences, New Campus, An-Najah National University, PO Box 7, Building 19, Office 1340, Nablus, Palestine. Email:
Am J Manag Care. 2021 Nov;27(11):480-486. doi: 10.37765/ajmc.2021.88775.
Hypertension is among the most commonly managed diseases in general practice. Therapeutic inertia could be responsible for the vast majority of cardiovascular events in patients with hypertension. The present study was conducted to explore views and opinions of clinicians involved in providing health care services to patients with hypertension in Palestine and achieve formal consensus on promoters of the phenomenon of therapeutic inertia from their point of view.
In this exploratory study, a mixed-methods approach combining literature search, qualitative interviews, and 2 Delphi technique rounds was used.
Interviews with key contact clinicians (n = 18) were conducted. To achieve formal consensus on promoters of therapeutic inertia in hypertension, 2 Delphi rounds were conducted using a panel of general practitioners, family medicine specialists, and internal medicine specialists (n = 50).
The majority of the panel members (90%) agreed that therapeutic inertia was prevalent in treating patients with hypertension in Palestine. Of the 41 potential promoters, consensus was achieved on 37 (90.2%). Of these 37 promoters, 21 (56.8%) were clinician-related, 10 (27.0%) were patient-related, and 6 (16.2%) were health care system-related factors. The study explored views and opinions of clinicians involved in providing health care services to patients with hypertension in Palestine relevant to therapeutic inertia in hypertension.
Findings of this study could inform policy and decision makers to devise strategies to eliminate or reduce therapeutic inertia in managing hypertension in Palestinian clinical practice. Future studies are needed to determine whether such strategies can improve outcomes of patients with hypertension.
高血压是普通科医生最常治疗的疾病之一。治疗惰性可能是高血压患者发生绝大多数心血管事件的原因。本研究旨在探讨参与为巴勒斯坦高血压患者提供医疗服务的临床医生的观点和意见，并从他们的角度就治疗惰性现象的推动者达成正式共识。
在这项探索性研究中，采用了结合文献检索、定性访谈和 2 轮 Delphi 技术的混合方法。
对关键联络临床医生（n=18）进行了访谈。为了就高血压治疗惰性的推动者达成正式共识，使用普通科医生、家庭医学专家和内科专家小组（n=50）进行了 2 轮 Delphi 调查。
大多数小组成员（90%）认为治疗惰性在治疗巴勒斯坦高血压患者中普遍存在。在 41 个潜在的推动者中，有 37 个（90.2%）达成了共识。在这 37 个推动者中，21 个（56.8%）与临床医生有关，10 个（27.0%）与患者有关，6 个（16.2%）与医疗保健系统有关。本研究探讨了参与为巴勒斯坦高血压患者提供医疗服务的临床医生对高血压治疗惰性的看法和意见。
本研究的结果可以为政策制定者和决策者提供信息，制定策略以消除或减少巴勒斯坦临床实践中治疗高血压的惰性。需要进一步研究以确定这些策略是否可以改善高血压患者的结局。
