Abstract:
Background: Therapeutic inertia may be one of the factors contributing to poor asthma
control. However, the magnitude of therapeutic inertia in asthmatic patients was not yet
determined. In Ethiopia, a result showed that more than 50% of people with asthma had
uncontrolled asthma (1). Identifying the major determinants of therapeutic inertia in different
asthma severity levels represents the initial step toward the improvement of overall patient
management.
Objective: to assess the prevalence of therapeutic Inertia and its determinant factors among
patients on bronchial asthma management at Jimma University Medical Center (JUMC).
Methods and participants: An institution-based cross-sectional study was conducted on
adult asthmatic patients attending chronic follow-up OPD from November 1 2022 to January
30, 2023. A consecutive sampling with an interviewer-administered questionnaire and patient
chart review was performed. Pearson’s chi-squared tests, binary and multivariable logistic
regression were employed for data analysis.
Results: The study included 132 asthmatic patients, with almost even gender distribution.
The median age was 47 years. Therapeutic inertia was identified in 63 (47.7%) of the study
subjects. Of these, 42 (31.8%) required treatment intensification, whereas 21 (15.9%) needed
medication de-escalation. The associated factors among patients on bronchial asthma
management were poor adherence to medications prescribed by a doctor (p-value= 0.013;
AOR 5.9; 95% CI 1.5-23.9), no regular follow-up (p-value=0.010; AOR 9.766; 95% CI
1.727-55.216), mild persistent chronic asthma (p-value <0.001;AOR 0.003; 95% CI 0.001-
0.069) and poor provision of verbal explanation about asthma medication(p-value <0.001;
AOR 0.113; 95% CI 0.049-0.261).
Conclusions: The prevalence of therapeutic inertia among asthmatic patients in JUMC was
high. The significant determinants were more patient-related factors than physician-related
factors. As patient-related factors, health-related behavior, asthma severity, poor compliance
to prescribed medication and poor follow-up were associated with therapeutic inertia, and
provision of verbal explanation about asthma medication was the only physician-related
factor associated with therapeutic inertia.
