Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Prim Care Diabetes. 2022 Jun;16(3):417-421. doi: 10.1016/j.pcd.2022.02.005. Epub 2022 Feb 24.
Clinical inertia behaviour affects family physicians managing chronic disease such as diabetes. Literature addressing clinical inertia in the management of hypoglycemia is scarce. The objectives of this study were to create a measurement for physician clinical inertia in managing hypoglycemia (ClinInert_InHypoDM), and to determine physicians' characteristics associated with clinical inertia.
The study was a secondary analysis of data provided by family physicians from the InHypo-DM Study, applying exploratory factor analysis. Principal axis factoring with an Oblimin rotation was employed to detect underlying factors associated with physician behaviors. Multiple linear regression was used to determine association between the ClinInert_InHypoDM scores and physician characteristics.
Factor analysis identified a statistically sound 12-item one-factor scale for clinical inertia behavior. No statistically significant differences in clinical inertia score for the studied independent variables were found.
This study provides a scale for assessing clinical inertia in the management of hypoglycemia. Further testing this scale in other family physician populations will provide deeper understanding about the characteristics and factors that influence clinical inertia. The knowledge derived from better understanding clinical inertia in primary care has potential to improve outcomes for patients with diabetes.
临床惯性行为会影响家庭医生管理糖尿病等慢性病。关于低血糖管理中临床惯性的文献很少。本研究的目的是创建一个衡量医生在管理低血糖时临床惯性的测量工具（ClinInert_InHypoDM），并确定与临床惯性相关的医生特征。
本研究是对 InHypo-DM 研究中家庭医生提供的数据进行的二次分析，应用探索性因素分析。采用主成分因子分析和 Oblimin 旋转来检测与医生行为相关的潜在因素。采用多元线性回归来确定 ClinInert_InHypoDM 评分与医生特征之间的关联。
因子分析确定了一个具有统计学意义的 12 项单因素临床惯性行为量表。在所研究的独立变量中，临床惯性评分没有统计学上的显著差异。
本研究提供了一个评估低血糖管理中临床惯性的量表。在其他家庭医生群体中进一步测试该量表将提供更深入的了解影响临床惯性的特征和因素。从更好地理解初级保健中的临床惯性中获得的知识有可能改善糖尿病患者的治疗效果。
