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Determinants and Explanatory Models of Clinical Inertia

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Clinical Inertia

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Abstract

In their initial publication, Phillips et al. proposed three main explanations of clinical inertia: denial, the use of soft reasons (the situation is improving, or, the patient is nonadherent anyway), and lack of physician training in the concept of treatment titration. Since then, other factors have been highlighted: uncertainty regarding the actual state of the patient (in particular blood pressure), and competing demands which draw the physician’s attention to acute issues, to the detriment of prevention measures. In this chapter we also analyze other reasons, such as the characteristics of the physicians, the fact that the patient belongs to an ethnic minority or is disadvantaged, and finally the relationship between physician clinical inertia and patient nonadherence. In the second part of this chapter, we discuss several theoretical models of clinical inertia, including the Knowledge–Attitude-Behavior-Result model described by Cabana, The Awareness-Agreement-Adoption-Adherence model, the Physician Guideline Compliance model, and the application to the clinical inertia issue of the Regulatory Focus Theory by Higgins, proposed by Veazie.

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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). Determinants and Explanatory Models of Clinical Inertia. In: Clinical Inertia. Springer, Cham. https://doi.org/10.1007/978-3-319-09882-1_4

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  • DOI: https://doi.org/10.1007/978-3-319-09882-1_4

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  • Print ISBN: 978-3-319-09881-4

  • Online ISBN: 978-3-319-09882-1

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