Family Physician Clinical Inertia in Managing Hypoglycemia

Caroline V M Rebicki; Bridget L Ryan; Alexandria Ratzki-Leewing; Paul F Tremblay; Stewart B Harris

doi:10.1016/j.pcd.2022.02.005

Family Physician Clinical Inertia in Managing Hypoglycemia

Prim Care Diabetes. 2022 Jun;16(3):417-421. doi: 10.1016/j.pcd.2022.02.005. Epub 2022 Feb 24.

Authors

Caroline V M Rebicki¹, Bridget L Ryan², Alexandria Ratzki-Leewing³, Paul F Tremblay⁴, Stewart B Harris⁵

Affiliations

¹ Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
² 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.
³ Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
⁴ Department of Psychology, Western University, London, Ontario, Canada.
⁵ 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. Electronic address: stewart.harris@schulich.uwo.ca.

PMID: 35221245
DOI: 10.1016/j.pcd.2022.02.005

Abstract

Aims: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Clinical Inertia; Exploratory Factor Analysis; Family Physician; Hypoglycemia.

MeSH terms

Chronic Disease
Humans
Hypoglycemia* / chemically induced
Hypoglycemia* / diagnosis
Hypoglycemia* / therapy
Physicians, Family*
Practice Patterns, Physicians'