Physician and Patient Characteristics Associated With Clinical Inertia in Blood Pressure Control
Article first published online: 7 AUG 2013
©2013 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 15, Issue 11, pages 820–824, November 2013
How to Cite
J Clin Hypertens (Greenwich). 2013;15:820–824. ©2013 Wiley Periodicals, Inc.
- Issue published online: 30 OCT 2013
- Article first published online: 7 AUG 2013
- Manuscript Accepted: 7 JUL 2013
- Manuscript Revised: 24 JUN 2013
- Manuscript Received: 25 APR 2013
Clinical inertia, the failure to adjust antihypertensive medications during patient visits with uncontrolled hypertension, is thought to be a common problem. This retrospective study used 5 years of electronic medical records from a multispecialty group practice to examine the association between physician and patient characteristics and clinical inertia. Hierarchical linear models (HLMs) were used to examine (1) differences in physician and patient characteristics among patients with and without clinical inertia, and (2) the association between clinical inertia and future uncontrolled hypertension. Overall, 66% of patients experienced clinical inertia. Clinical inertia was associated with one physician characteristic, patient volume (odds ratio [OR]=0.998). However, clinical inertia was associated with multiple patient characteristics, including patient age (OR=1.021), commercial insurance (OR=0.804), and obesity (OR=1.805). Finally, patients with clinical inertia had 2.9 times the odds of uncontrolled hypertension at their final visit in the study period. These findings may aid the design of interventions to reduce clinical inertia.