Key result
The COVID-19 pandemic period did not significantly affect true therapeutic inertia in hypertension management compared to the pre-pandemic period (adjusted OR 0.82).
Why the study?
The COVID-19 pandemic affected health-care systems, including HT care, prompting an assessment of its impact on therapeutic inertia and its predictors in patients with HT.
Does the COVID-19 pandemic affect therapeutic inertia in patients with hypertension?
Cross-Sectional (n=8,941)
No
Does the COVID-19 pandemic affect therapeutic inertia in patients with hypertension?
The COVID-19 pandemic did not significantly worsen therapeutic inertia in hypertension management at a primary care clinic in Thailand.
Pandemic-era therapeutic inertia in hypertension was unchanged in this Thai cohort; leaves open generalizability and requires confirmation in broader settings.
INTRODUCTION: Hypertension (HT) has a significant impact on health care worldwide. Therapeutic inertia (TI) is defined as the failure to intensify therapy in the absence of an optimal goal and is widely used as a quality of care parameter. The coronavirus disease 2019 (COVID-19) pandemic has affected many health-care systems, including HT care. Therefore, the present study assessed the impact of the COVID-19 pandemic on TI and its predictors in patients with HT. METHODS: The electronic medical records of patients with HT who attended a primary care clinic at a tertiary hospital during pre-COVID-19 (February 2019 to February 2020) and COVID-19 (March to August 2020) periods were reviewed. RESULTS: Our study included 6089 visits during the 12-month pre-COVID-19 period and 2852 visits during the 6-month COVID-19 period. Most of the baseline characteristics of the HT patients were not significantly different between the two time periods. During the COVID-19 period, the percentage of uncontrolled HT visits decreased from 43% to 31%. Similarly, the prevalence of TI decreased from 81% to 77%. False TI was predominantly due to physicians' concerns regarding the in-clinic blood pressure measurement being inaccurate during both the periods. CONCLUSION: After readjustment for the physicians 'reasons, the true TI was 64% and 60% in the pre-COVID-19 and COVID-19 period. For adjusted physician and patient-related factors, multilevel modeling was used. Senior medical staff visits, elderly patients, prior diabetes mellitus diagnosis, patients who used more than one type of anti-HT medication, and patients with systolic blood pressure >150 mmHg were all predictors of TI. The COVID-19 period, on the other hand had no effect on TI with an adjusted odds ratio of 0.82 (95% confidence interval, 0.67-1.01).
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Sornsenee et al. (2021) conducted a cross-sectional in Hypertension (n=8,941). COVID-19 pandemic period vs. Pre-COVID-19 period was evaluated on True therapeutic inertia (OR 0.82, 95% CI 0.67-1.01). The COVID-19 pandemic period did not significantly affect true therapeutic inertia in hypertension management compared to the pre-pandemic period (adjusted OR 0.82).
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