Therapeutic inertia is the failure to initiate, intensify—or sometimes de-intensify—therapy when a patient’s therapeutic goals are not met. It is a common problem in the management of type 2 diabetes. A symposium on Friday afternoon featured a multidisciplinary panel of diabetes care professionals who discussed the causes and implications of therapeutic inertia and strategies to combat it.

The session, Overcoming Therapeutic Inertia—Leveraging the Diabetes Care Interprofessional Team, can be viewed on-demand by registered meeting participants at ADA2023.org. If you haven’t registered for the 83rd Scientific Sessions, register today to access the valuable meeting content through August 28.

“Therapeutic inertia significantly impacts the effective management of diabetes, leading to suboptimal patient outcomes,” said Symposium Chair Nuha Ali El Sayed, MD, MMSc, Endocrinologist at Joslin Diabetes Center and Vice President of Health Care Improvement at the American Diabetes Association^® (ADA). “We are learning more about the causes and implications of this phenomenon and exploring innovative strategies to combat it. By doing so, we will improve our practice in diabetes care and improve the lives of our patients affected by this condition.”

Despite clear and well-established definitions of appropriate A1C targets and the availability of effective therapies and evidence-based guidelines, therapeutic inertia is recognized as one of the key reasons when glycemic control fails to improve, said Kevin M. Pantalone, DO, ECNU, FACE, Staff Endocrinologist and Director of Diabetes Initiatives at the Cleveland Clinic.

“Early intensive glycemic control is known to reduce the risk of long-term diabetes-related complications; however, therapeutic inertia can be present at diagnosis or at any stage along the patient’s treatment journey,” he said. “Timing is everything in diabetes treatment. A key concept in therapeutic inertia is acting quickly to achieve glycemic targets and A1C goals with one year of treatment.”

Another key concept in combating therapeutic inertia is leveraging the entire health care team, including diabetes educators and dietitians, according to Lucia M. Novak, MSN, ANP-BC, BC-ADM, Nurse Practitioner in Adult Health and Advanced Diabetes Management and President of Diabesity, LLC. There are often challenges, however, she said.

“Barriers, such as access to care, and things like prior authorizations can make it very difficult sometimes,” Ms. Novak said. “No patient intends to be non-adherent or non-compliant. There is always an underlying reason, and we work as a team with our patients to try and figure out what that is and try to bust that barrier.”

The availability of and access to patient electronic health records (EHR) can be a valuable tool in facilitating multidisciplinary cooperation and counteracting therapeutic inertia, said Sandra Leal, PharmD, MPH, FAPhA, CDCES, Vice President of Pharmacy Practice Innovation and Advocacy at CVS Health.

“As a pharmacist, what we try to do is work together closely with other providers, and one of the things I’m seeing is more available access of patients’ EHRs for pharmacists to be able to communicate with the primary provider and the diabetes care team,” she said. “From the EHR, we can look to see which patients are due for an A1C and who has a gap in care. It is estimated that up to 22% of patients don’t even realize that they need an A1C, so the simple act of communicating it and being in touch with that patient provides an opportunity to intervene.”

For more information, resources, and tools to combat therapeutic inertia, explore the ADA’s Overcoming Therapeutic Inertia (OTI) initiative, designed to help physicians, nurse practitioners, physician assistants, pharmacists, dietitians, and diabetes educators more effectively partner with their patients to implement the most effective care strategies for proper glycemic control.