Diabetes Pro Quarterly - Fall 2020 - 7

Professional Education News

Simple Strategies for Busting Through Inertia in Your Practice
The American Diabetes
Association's (ADA's)
multi-year Overcoming
Therapeutic Inertia (OTI) initiative has brought together leading
diabetes researchers and clinicians to understand contributors
to therapeutic inertia (TI) and identify practical solutions that
can be easily implemented in primary care. Findings from a
systematic review, combined with robust consensus-building
discussions, have informed the development of an OTI Best
Practices Framework and educational curriculum, both
foundational to this initiative. On August 12, the OTI education
and awareness campaign kicked off with a webinar titled

facilitate medication management; others focus on improving the
overall quality and quantity of patient engagement through the
use of technology and innovative coaching programs. Two factors
appear to be absolutely crucial to any effective approach:

TI is far too common in the care of people with diabetes.
Defined as the failure to initiate, intensify, or deintensify the
therapy regimen as needed when a patient's treatment goals
are not met, it increases risks for all severe diabetes-related
complications. This phenomenon has been observed for more
than 20 years and continues to be a problem that touches
all points of the diabetes care continuum. In contrast to the
treatment delays resulting from TI, people who reach their A1C
targets soon after finding out they have diabetes are more likely
to keep their glucose levels within their target ranges. This welldocumented "legacy effect" continues to reduce health risks many
years later, even if a patient's A1C eventually creeps up.

"There is a lot you can control and a lot you can't in diabetes
care," notes Eden Miller, DO, a diabetologist and member of
the OTI Steering Committee. "So, I work hard to focus on what
I can control. For me, this means doing something to optimize
therapy at every visit when a patient is above goal. It also means
asking every patient about the challenges they may be having
with managing their diabetes. The bottom line? I want to make
sure that therapeutic inertia can never be traced back to me!"

"Overcoming Therapeutic Inertia: What You Need to
Know." More than 850 clinicians registered.

The OTI initiative is spreading the word that overcoming TI
has never been more possible than it is today. Effective strategies
exist, but all require both identifying patients experiencing TI and
engaging the entire care team in providing support and education.
Some successful approaches leverage nonphysician clinicians to

1. Timely therapy optimization. Noticing who is at risk and
doing something at every visit when a patient is not at target.
This component presupposes that glycemic targets and a time
frame to reach them are determined through shared decisionmaking with patients.
2. Improved care plan adherence. This component depends
on continuously monitoring and addressing barriers to care
plan follow-through, including actively addressing social,
emotional, and financial challenges.

The OTI Best Practices Framework identifies 15 actions that can
help address TI. Here are five to consider. Pick one you think you
can implement within the next month.
1. Use your electronic health record system's tools, such as a
patient registry, to regularly identify patients who may be
experiencing TI, and then reach out to them. Run reports on
a monthly or quarterly basis. For example, obtain a list of all
patients whose last A1C was >8% and who have had no office
visit in the past 6 months.

Coming Soon:
Non-CE Eye Health Education
for Diabetes Care Providers
Learn more at eyehealth.diabetes.org

Diabetes is Primary
2020 Webcasts Available
From now until December 31, view our
Diabetes is Primary 2020 webcasts for
continuing education credit.
Visit ADA's professional education offerings
for more information.

professional.diabetes.org

https://professional.diabetes.org/meetings/best-practices-framework https://professional.diabetes.org/meetings/best-practices-framework https://professional.diabetes.org/meetings/overcoming-ti-what-you-need-know https://professional.diabetes.org/meetings/overcoming-ti-what-you-need-know https://eyehealth.diabetes.org https://ada.healthmonix.com/allcourses?Name=diabetes+is+primary&TagId=7 http://professional.diabetes.org

Diabetes Pro Quarterly - Fall 2020

Table of Contents for the Digital Edition of Diabetes Pro Quarterly - Fall 2020