Factors Associated with Diabetes-Related Clinical Inertia in a Managed Care Population and Its Effect on Hemoglobin A1c Goal Attainment: A Claims-Based Analysis

Journal of Managed Care & Specialty Pharmacy
Natalia Ruiz-NegrónBrandon K Bellows

Abstract

Despite evidence showing the benefits of treatment intensification following an elevated hemoglobin A1c (A1c), clinical inertia, or failure to establish and/or escalate treatment to achieve treatment goals, is a concern among patients diagnosed with type 2 diabetes (T2DM). Clinical inertia may contribute to increased health care utilization and costs due to poor clinical outcomes in MCOs. To (a) identify factors associated with clinical inertia in T2DM and (b) determine differences in A1c goal attainment between patients who experience clinical inertia versus treatment intensification in a commercially insured population. Medical and pharmacy claims data were used to identify commercially insured patients in a regional MCO with a recorded A1c ≥ 8.0% between January 1, 2013, and December 31, 2015. In the 4 months following the first elevated A1c value (index date), patients were classified into 2 groups: treatment intensification or clinical inertia. Treatment intensification was defined as the addition of ≥ 1 new noninsulin antihyperglycemic medication, the addition of insulin, or a dose increase of any current noninsulin antihyperglycemic medication. Patients were required to have ≥ 1 follow-up A1c value 6-12 months after the ...Continue Reading

References

Jun 10, 2008·The New England Journal of Medicine·Anushka PatelFlorence Travert
Jun 16, 2012·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Elizabeth MarrettMark N Feinglos
Jan 23, 2014·The Annals of Pharmacotherapy·James DavisDeborah T Juarez
Feb 11, 2015·Diabetes Research and Clinical Practice·Robert J RomanelliLatha Palaniappan
Oct 23, 2015·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Jay LinPhilip Levin
Jul 21, 2016·JAMA : the Journal of the American Medical Association·Suetonia C PalmerGiovanni F M Strippoli
Oct 12, 2016·Primary Care Diabetes·Kamlesh Khunti, David Millar-Jones
Dec 10, 2017·Diabetes Care·UNKNOWN American Diabetes Association
Mar 24, 2018·Diabetes Care·UNKNOWN American Diabetes Association

❮ Previous
Next ❯

Citations

Jun 18, 2020·Journal of Evaluation in Clinical Practice·Ashley H MeredithJasmine D Gonzalvo

❮ Previous
Next ❯

Related Concepts

Related Feeds

Biomarkers for Type 2 Diabetes

Biomarkers can help understand chronic diseases and assist in risk prediction for prevention and early detection of diseases. Here is the latest research on biomarkers in type 2 diabetes, a disease in which the body is unable to produce or properly use insulin.