Prevalence of therapeutic inertia and its associated factors among patients on bronchial asthma management at Jimma University Medical Center. Jimma, Southwest, Ethiopia.

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.