Investigation of Therapeutic Inertia and Influencing Factors in Primary Care Physicians During Hypertension Diagnosis and Treatment Process postprint

Abstract: Background  Hypertension is a common chronic disease that seriously endangers the health of the population. The primary-care doctors are the main force in the management of hypertension. However，the doctor-induced therapeutic of inertia greatly affects the achievement of primary-care hypertension control. Objective  The aim of this study is to investigate the current status of therapeutic inertia among primary healthcare providers in the diagnosis and treatment process of hypertension，and analyze the causes of therapeutic inertia，providing a reference basis for improving hypertension control rates in China. Methods  A simple random sampling method was used to distribute questionnaires to primary healthcare providers in 32 primary healthcare institutions in Tianjin from July to August 2023. The therapeutic inertia in the diagnosis and treatment process of hypertension was evaluated from three dimensions: knowledge mastery of hypertension diagnosis and treatment，“soft reasons”and “overestimation of treatment efficacy” as well as “medical insurance policies.” Binary logistic regression analysis was employed to explore the influencing factors of therapeutic inertia.Results  A total of 407 questionnaires were distributed in this study，and 386 valid questionnaires were collected，yielding an effective response rate of 97.96%. (1) The average score for primary healthcare providers' knowledge of hypertension diagnosis and treatment was 6 (0.5)，with a scoring rate of 61.19% (5.50/9.00). The total score for therapeutic inertia in hypertension management was 48 (7.0)，with a scoring rate of 56.55% (45.24/80.00). (2) The scores for the “soft reasons” dimension，“overestimation of treatment efficacy” dimension，and “medical insurance policies” dimension were 26 (4.8)，10 (2.0)，and 6 (2.5) respectively，with scoring rates of 51.97% (25.89/50.00)，65.42% (9.81/15.00)，and 44.64% (6.96/15.00) respectively. When comparing the average scores of the three dimensions of therapeutic inertia，the “medical insurance policies” dimension had the lowest score compared to the other two groups (P<0.05). Multivariate analysis showed that male gender，rural areas，lower mastery of hypertension diagnosis and treatment knowledge，and a weekly patient volume of less than 10 hypertensive individuals were associated with a higher tendency towards therapeutic inertia among primary healthcare providers (P<0.05). Conclusion  therapeutic inertia is prevalent among primary healthcare providers in the diagnosis and treatment process of hypertension. Low levels of hypertension treatment cognition，overestimation of treatment efficacy，and “soft reasons” are the primary factors contributing to therapeutic inertia among primary healthcare providers. It is recommended to strengthen education on therapeutic inertia in hypertension，conduct diversified training on diagnostic and management knowledge，and promote clinical informatization and artificial intelligence decision-making systems to effectively improve the therapeutic inertia of primary healthcare providers in hypertension management.