Reasons for therapeutic inertia when managing hypertension in clinical practice in non-Western countries

Ferrari, Paolo

doi:10.1038/jhh.2008.117

Cited by 57 publications

(40 citation statements)

References 31 publications

(40 reference statements)

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“…We do not have information about provider attitudes and beliefs, which have also been shown to also be a key factor in clinical inertia. 26,27 Again, our analysis may account for some of this variability, but not all.…”

Section: Discussionmentioning

confidence: 90%

Understanding Racial Disparities in Treatment Intensification for Hypertension Management

et al. 2010

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Section: Discussionmentioning

confidence: 90%

Understanding Racial Disparities in Treatment Intensification for Hypertension Management

et al. 2010

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“…A previous study found that in a cohort of hypertensive patients that had not less than four visits and at least one instance of elevated BP, treatment modifications occurred only among 13.1% of total patients with uncontrolled BP [14]. One of the common reasons cited by healthcare providers for not prescribing treatment modification in the Reasons for not Intensifying Antihypertensive Treatment (RIAT) trial was the assumption that the time after starting the new drug is too short to attain full effect [31]. The average time for addition or uptitration of hypertension treatment in our study was more than 100 days.…”

Section: Discussionmentioning

confidence: 97%

Patterns of treatment modifications among newly treated hypertensive patients

Sonawane¹,

Qian²,

Garza³

et al. 2016

Journal of Hypertension

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“…7,8 Faktor dokter untuk mengintensifikasi terapi sangat berpengaruh dalam pencapaian target TD 9 , dan lebih sering dijumpai jika dibandingkan faktor ketaatan pasien. 10,11 Suatu intervensi pemberian umpan balik TD kepada dokter meningkatkan pengendalian TD.…”

Section: 6unclassified

The Effect of Blood Pressure Feedback Intervention to Doctors on the Change of the Hypertensive Patient Therapy Cost

Suhadi

Thobari

Irawan

et al. 2015

Indones J Clin Pharm

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AbstrakSuatu penelitian intervensi analitik telah dilakukan dengan tujuan untuk mengevaluasi cost-effectiveness terapi pasien rawat jalan hipertensi di empat rumah sakit (RS) di Kota Yogyakarta. Penelitian dilakukan dengan metode grafik scatter-plot; aksis-X dan aksis-Y menunjukkan selisih tekanan darah (TD) dan biaya antar kelompok. Pemberian umpan balik TD diberikan kepada dokter spesialis perlakuan sebanyak empat kali setelah informed consent, sementara dokter kontrol menjalani terapi secara alamiah. Pasien dari dokter subjek >18tahun, menerima antihipertensi, Askes *, ≥4 kali kunjungan, dan ≥1 kali TD sistolik (TDS) ≥140mmHg diikutkan penelitian. Data terapi, TD, dan biaya terapi pasien dikumpulkan selama 8 bulan secara prospektif sejak intervensi pertama dari catatan medik pasien dan klaim pembayaran RS kepada Askes. Seluruh biaya terkait hipertensi dan kardiovaskular dengan perspektif RS diikutkan analisis. Data diperoleh dari rekam medik dan klaim biaya terapi oleh RS kepada PT. Askes. Hipotesis: proporsi pasien di kuadran kanan grafik mencapai ≥90%. Kuadran kanan menunjukkan TDS perlakuan lebih baik. Hasil penelitian menunjukkan pasien perlakuan (n=379) dan kontrol (n=266) tidak berbeda bermakna untuk umur, jender, TD, dan jumlah antihipertensi. Pasien perlakuan memiliki TD diastolik lebih baik, biaya antihipertensi per kunjungan lebih tinggi (p<0,05) tetapi sama untuk obat kardiovaskular serta biaya total (p>0,05). Proporsi pasien kuadran kanan sebesar 56,2%. Analisis subgrup pada perempuan, tanpa umur 80-90tahun, TDS final≤160mmHg, rerata TDS ≤150mmHg, dan antihipertensi 1-3 item diperoleh proporsi kuadran kanan 66,9% tetapi belum mencapai 90%. Pemberian umpan balik TD kepada dokter meningkatkan proporsi pasien di kuadran kanan meskipun belum mencapai proporsi yang diharapkan.*Askes pada saat sekarang ini sudah berubah menjadi Jaminan Kesehatan Nasional oleh BPJS Kata kunci: Biaya terapi, cost-effectiveness, hipertensi, umpan balik tekanan darah kepada dokter The Effect of Blood Pressure Feedback Intervention to Doctors on the Change of the Hypertensive Patient Therapy Cost AbstractAn analytical intervention study has been done with the aim to evaluate the therapy cost-effectiveness among the hypertensive ambulatory patients at four hospitals in Yogyakarta city. The study was done with the scatter-plot method; x-axis and y-axis were for the difference of blood pressure and therapy cost between groups respectively. Blood pressure feedback intervention was delivered monthly for four times to the specialists in the intervention group since the informed-consent approval. The control specialists preceded the natural practice. The included patients were the specialist's subjects with the following criteria: >18 years, "Askes"-insured, ≥4 visits, and ≥1 visit with systolic blood pressure (SBP) ≥140mmHg. The medication profile, BP level, and therapy cost profile were collected prospectively for eight months since the first intervention from medical record and the hospital claim to Askes. All hypertensive and c...

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Reasons for therapeutic inertia when managing hypertension in clinical practice in non-Western countries

Cited by 57 publications

References 31 publications

Understanding Racial Disparities in Treatment Intensification for Hypertension Management

Understanding Racial Disparities in Treatment Intensification for Hypertension Management

Patterns of treatment modifications among newly treated hypertensive patients

The Effect of Blood Pressure Feedback Intervention to Doctors on the Change of the Hypertensive Patient Therapy Cost

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