BMJ  2007;335:542-544 (15 September), doi:10.1136/bmj.39259.400069.AD

Analysis

Tackling therapeutic inertia: role of treatment data in quality indicators

¹ Community Health Sciences, University of Dundee, Dundee DD2 4BF, ² Department of Family Medicine and General Practice, Royal College of Surgeons in Ireland, Dublin 2, Ireland

Many patients with hypertension remain undertreated despite the apparent rosy picture given by doctors meeting current targets. Different measures are needed to overcome therapeutic inertia, argue Bruce Guthrie, Melanie Inkster, and Tom Fahey

The first 150 words of the full text of this article appear below.

Inadequate management of risk factors for conditions such as hypertension, diabetes, and coronary heart disease remains an important international challenge.¹ One approach is to set healthcare providers targets for blood pressure, glycated haemoglobin, or cholesterol levels in their populations. Such targets are commonly used as an indicator of quality of health care^{2 3} and are increasingly being incorporated into programmes that pay providers for performance. However, we show that fixed targets fail to identify clear opportunities for improving health care. We propose that future measures should include information on process of care information, which is more closely linked to better control of risk factors.²

Evidence from observational studies

Poor control of hypertension is defined as a failure to meet recommended blood pressure goals. Barriers to controlling hypertension include patient factors, such as non-adherence to lifestyle advice or drug treatment,⁴ and healthcare provider factors, including the organisation or environment where care is delivered.^{1 5 6} As measurement of . . . [Full text of this article]

Treatment intensification: definition and predictors

Evidence from randomised controlled trials

Use of process information to assess care

Summary points

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This article has been cited by other articles:

• Guthrie, B. (2008). Measuring the quality of healthcare systems using composites. BMJ 337: a639-a639 [Full text]  
• Professor the Lord Darzi of Denham, (2008). Evidence-based medicine and the NHS: a commentary. JRSM 101: 342-344 [Full text]  
• Wald, D. S (2007). Problems with performance related pay in primary care. BMJ 335: 523-523 [Full text]