Identification of therapeutic inertia in the management of patients living with Diabetes in Family Medicine Units
Juan Carlos TOMAS LÓEZ, Eugenia Del Rocio RIVERA TELLO, Hector Raul VARGAS SANCHEZ and Elizabandh GUZMAN MEDINA
The Mexican Social Security Institute (IMSS) is the largest healthcare institution in Mexico. It has 54 million beneficiaries, of whom 5.3 million are diagnosed with diabetes. The target for fasting glucose control is at least 40% (fasting plasma glucose between 70 and 130 mg/dL).One of the potential causes for not achieving the control target is therapeutic inertia, which is present in a certain proportion of primary care physicians. To identify therapeutic inertia, the IMSS Family Medicine Division developed an evaluation tool, consisting of a retrospective review of medical records to identify the therapeutic adjustments made by physicians in the last 6 months of care. During 2024, the tool was implemented in 1,250 Family Medicine Units nationwide, through department heads or unit directors.The following results were identified: More than 12,000 patient records were reviewed each month. The results were analyzed quarterly In the first quarter, 47% of patients underwent therapeutic adjustments, increasing to 64% in the last quarter of 2024, with an annual average of 55.7%. The average for the first half of 2025 was 63%.There is therapeutic inertia in primary care, so mechanisms will be established to easily identify it and provide feedback to physicians. The implementation of Pharmacological Control facilitated adjustments to the pharmacological treatment of patients with diabetes, improving glycemic control. At the Mexican Social Security Institute (IMSS), this tool will continue to be implemented in Family Medicine Units, and training for primary care physicians on making therapeutic adjustments for diabetes will continue.It is possible to create agile monitoring and evaluation tools for primary care medical staff to advise and change pharmacological prescribing behaviors, for the benefit of patientsIt is important and necessary to create tools to identify therapeutic inertia in primary care physicians, to provide guidance and change prescribing behavior in order to improve metabolic control in persons living with type 2 diabetes
