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Review
. 2018 Jan 29;20(1):4.
doi: 10.1007/s11906-018-0802-1.

Therapeutic Inertia and Treatment Intensification

Robina Josiah Willock  1 , Joseph B Miller  2 , Michelle Mohyi  3 , Ahmed Abuzaanona  3 , Meri Muminovic  4 , Phillip D Levy  5
Affiliations
Review

Therapeutic Inertia and Treatment Intensification

Robina Josiah Willock et al. Curr Hypertens Rep. .

Abstract

Purpose of review: This review aims to emphasize how therapeutic inertia, the failure of clinicians to intensify treatment when blood pressure rises or remains above therapeutic goals, contributes to suboptimal blood pressure control in hypertensive populations.

Recent findings: Studies reveal that the therapeutic inertia is quite common and contributes to suboptimal blood pressure control. Quality improvement programs and standardized approaches to support antihypertensive treatment intensification are ways to combat therapeutic inertia. Furthermore, programs that utilize non-physician medical professionals such as pharmacists and nurses demonstrate promise in mitigating the effects of this important problem. Therapeutic inertia impedes antihypertensive management and requires a broad effort to reduce its effects. There is an ongoing need for renewed focus and research in this area to improve hypertension control.

Keywords: Antihypertensive therapy; HTN management; Hypertension control; Therapeutic inertia; Treatment intensification.

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Conflict of interest statement

Conflict of Interest The authors declare no conflicts of interest relevant to this manuscript.

Figures

Fig. 1
Fig. 1
Clinical algorithm for treatment intensification based on therapeutic intensity score and JNC-8 guidelines. Primary medication classes for treatment per JNC-8 guidelines include thiazide-type diuretic, angiotensin-converting enzyme inhibitor, angiotensin II receptor blocker, or calcium channel blocker TIS, therapeutic intensity score; JNC-8, Eighth Joint National Committee
See this image and copyright information in PMC

References

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      •This article is an excellent introduction to the concept of therapeutic inertia.

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