Therapeutic Inertia in Glycemic Management: A Hidden Driver of Poor Diabetes Control and Suboptimal Outcomes: Findings from a Retrospective Cohort Study in Ethiopia

This retrospective cohort study investigated the effect of therapeutic inertia on treatment outcomes in patients with type 2 diabetes receiving care at a tertiary hospital in southern Ethiopia. A retrospective cohort study was conducted among 159 adult ambulatory type 2 diabetic patients between June 2020 and 2023. We collected the data from medical records and used EpiData version 4.6 for data entry and SPSS version 25 for analysis. Independent sample t tests, Fisher’s exact tests and chi-square tests were used for data analysis as appropriate. To assess the effect of therapeutic inertia on diabetic treatment outcomes, we applied a Cox proportional hazard model. A p value of less than 0.05 was considered statistically significant. In this study, we reviewed the medical records of type 2 diabetic patients. Poor treatment outcomes were common in the therapeutic inertia group (68.63%). There was a statistically significant difference between groups in the type of physician managing the patients (p = 0.01). Furthermore, the presence of comorbidities (p = 0.024), the mean fasting plasma glucose level (p = 0.01), neuropathy (p = 0.02) and nephropathy (p = 0.011) were significantly associated with therapeutic inertia. The therapeutic inertia exposure group was significantly associated with an increased risk of poor treatment outcomes, with an adjusted HR of 1.927 (95% CI: 1.201–3.092, p = 0.007). Our study revealed that therapeutic inertia worsened diabetic treatment outcomes among type 2 diabetes patients. This underlines that healthcare providers should prioritize proactive management, such as regular reassessment of treatment efficacy and prompt adjustment of therapies, to improve patient outcomes.