Surrati Amal M Qasem, Alshanqiti Asma, Albadrani Muayad, AlHarbi Mansour, Abu Baker Tobaiqi Muhammad
Department of Family and Community Medicine, Taibah University, Madinah, Saudi Arabia.
Diabetes Center, King Fahd Hospital, Madinah, Saudi Arabia.
J Pak Med Assoc. 2025 Jun;75(6):892-901. doi: 10.47391/JPMA.11538.
To explore the knowledge and perceptions of primary care physicians about clinical inertia in the management of type 2 diabetes, and to identify the contributing factors.
The cross-sectional study was conducted in Madinah, Saudi Arabia between April and May 2020, and comprised qualified doctors working in primary care centres as general practitioners or board-certified family physicians. Data was collected using a questionnaire on participants' demographics, knowledge and practices related to diabetes management, and their perceptions regarding clinical inertia in the management of type 2 diabetes. The questionnaire was distributed online. Data was analysed using SPSS 28.
Of the 250 subjects approached, 200 (80%) completed the questionnaire; 105(52.5%) males and 95(47.5%) females. There were 78 (39%) subjects aged 41-50 years. Overall, 90(45%) subjects were general practitioners, 41(20.5%) were family medicine specialists, and 62(31%) were family medicine consultants. Of the total, 96(48%) respondents were aware of the concept of therapeutic inertia. Factors contributing to inertia were identified at the patient, physician and system levels. Physician-related factors included concern about hypoglycaemia 129(64.5%), complexity of treatment 111(55.5%), and patient refusal 67(33.5%). Patient-related barriers were resistance to lifestyle modifications 132 (66.0%), fear of weight gain 105(52.5%), and fear of injections 101(50.5%). System-level barriers included lack of multidisciplinary teams 137(68.5%), time constraints 107 (53.5%), and high workload 104(52.0%). A significant association was found between professional classification and awareness of therapeutic inertia (p<0.05).
Addressing barriers at the physician and system levels could help reduce clinical inertia in insulin prescription, potentially leading to improved diabetes outcomes.
探讨基层医疗医生对2型糖尿病管理中临床惰性的认识和看法，并确定相关影响因素。
2020年4月至5月在沙特阿拉伯麦地那进行了一项横断面研究，研究对象为在基层医疗中心工作的合格医生，包括全科医生或获得委员会认证的家庭医生。通过一份问卷收集数据，内容涉及参与者的人口统计学信息、与糖尿病管理相关的知识和实践，以及他们对2型糖尿病管理中临床惰性的看法。问卷通过网络发放。使用SPSS 28进行数据分析。
在接触的250名受试者中，200名（80%）完成了问卷；男性105名（52.5%），女性95名（47.5%）。年龄在41 - 50岁的受试者有78名（39%）。总体而言，90名（45%）受试者为全科医生，41名（20.5%）为家庭医学专科医生，62名（31%）为家庭医学顾问。在所有受访者中，96名（48%）知晓治疗惰性的概念。在患者、医生和系统层面均发现了导致惰性的因素。与医生相关的因素包括对低血糖的担忧（129名，64.5%）、治疗复杂性（111名，55.5%）以及患者拒绝（67名，33.5%）。与患者相关的障碍包括对生活方式改变的抵触（132名，66.0%）、对体重增加的恐惧（105名，52.5%）以及对注射的恐惧（101名，50.5%）。系统层面的障碍包括缺乏多学科团队（137名，68.5%）、时间限制（107名，53.5%）和工作量大（104名，52.0%）。发现专业分类与治疗惰性的知晓情况之间存在显著关联（p<0.05）。
解决医生和系统层面的障碍有助于减少胰岛素处方中的临床惰性，可能改善糖尿病治疗效果。
