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Evaluation of a toolkit for reducing primary care inertia

Evaluation of a toolkit for reducing therapeutic inertia in primary care

What we are doing:

A toolkit designed to interrogate primary care database at practice level is being developed to focus on patients in whom HbA1c continues to remain above the recommended target of 7% or blood pressure above 140/80 mmhg or QRISK2 abover 10% without any attempt to initiate or intensify medications. The toolkit will also identify older patients with HbA1c <7% (53 mmol/mol) for de-intensifications. 

Why we are doing it:

A retrospective cohort study to evaluate the effect of the delay in treatment CVE showed that compared to patients with HbA1c <7% (<53 mmol/mol), in patients with HbA1c ≥7% (≥53 mmol/mol), a one-year delay in receiving IT was associated with significantly increased risk of MI, stroke, HF and composite CVE by 67% (HR CI: 1.39, 2.01), 51% (HR CI: 1.25, 1.83), 64% (HR CI: 1.40, 1.91) and 62% (HR CI: 1.46, 1.80) respectively.

What the benefits will be:

A successful implementation of this pilot will help reduce the scale of therapeutic inertia, and prevent the associated CVE in the proportions listed above. If this pilot is deemed a success, its aim is to disseminate to the rest of the country via NHS England.

Who we are working with:

  • Leicester City CCG
  • EDEN (Leicester Diabetes Centre)

Study lead:

Name: Dr Sam Seidu

Role: Research Fellow

Organisation: Diabetes Research Centre, University of Leicester


Kerry Hulley,