Patrick D Byrnes
An evidence practice gap is defined as the ‘difference between what we know from best available research evidence and what actually happens in current practice’.1 The relatively new concept of ‘therapeutic inertia’ is useful to understand why these gaps occur. The term first appeared in the MEDLINE indexed literature in a 2004 article2 which referred to the 2001 paper by Phillips et al.3 Although therapeutic inertia is sometimes used to mean failure to use pharmacological agents,4 a 2009 literature review5 found it is used more broadly for all types of therapy and interchangeably with the term ‘clinical inertia’.
There are multiple gaps between evidence and practice
in our health system. The relatively new concept of
‘therapeutic inertia’ is useful to understand why these
gaps persist. It is defined as ‘failure of healthcare providers
to initiate or intensify therapy when indicated’ and
‘recognition of the problem, but failure to act’.
This article explores the development of therapeutic inertia
and its causes, and other concepts useful in closing gaps in
general practice, including addressing emotional decisional
making by doctors.
Clinical inertia is the original term used to describe
gaps in practice; and therapeutic inertia is now used
interchangeably with it. The author illustrates his practice’s
approach to overcoming therapeutic inertia. The National
Institute for Clinical Studies was set up in Australia to
get the best available evidence from health and medical
research into everyday practice to help close these gaps.
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