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The Evidence: The Gap Between Guidelines and Clinical Reality

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Clinical Inertia

Abstract

The phenomenon of clinical inertia represents a barrier to the efficiency of care in most chronic diseases. The purpose of this chapter is to review the recent literature, analyzing a hundred references, demonstrating the breadth of the phenomenon and its consequences, in particular in term of loss of chance for the patient: for example, lack of treatment intensification of diabetes or hypertension represents a cause of persistent disequilibrium which can have severe consequences on the appearance of complications of these diseases. This chapter analyzes in detail the data concerning clinical inertia in the following diseases: diabetes (a particular case of clinical inertia is the “psychological insulin resistance” of physicians who avoid prescription of insulin), hypertension, hyperlipidemia, cardiovascular risk, heart failure, cardiac valvular diseases, complete arrhythmia due to atrial fibrillation, asthma, osteoporosis, and gives bibliographical references concerning other diseases.

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  1. Avicenne Hospital and Paris 13 University, Sorbonne Paris Cité, Bobigny, France

    Gérard Reach

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Reach, G. (2015). The Evidence: The Gap Between Guidelines and Clinical Reality. In: Clinical Inertia. Springer, Cham. https://doi.org/10.1007/978-3-319-09882-1_3

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  • DOI: https://doi.org/10.1007/978-3-319-09882-1_3

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