Factors associated with therapeutic Inertia in treatment of hyperglycaemia in patients with type two diabetes at Mbale regional referral hospital.
| dc.contributor.author | Mulomi, Ivan | |
| dc.date.accessioned | 2026-07-30T09:32:08Z | |
| dc.date.available | 2026-07-30T09:32:08Z | |
| dc.date.issued | 2026-07-30 | |
| dc.description | Factors associated with therapeutic inertia in treatment of hyperglycaemia among T2DM patients at MRRH. Therapeutic inertia refers to failure to intensify therapy in timely manner incase targets are not met | |
| dc.description.abstract | Background: Therapeutic inertia (TI) remains a critical systemic failure in achieving optimal glycaemic control globally, particularly within resource-constrained settings. At Mbale Regional Referral Hospital (MRRH) in Eastern Uganda, a substantial proportion of patients with Type 2 Diabetes Mellitus (T2DM) present with persistently elevated blood glucose levels despite routine clinical appointments, though localized operational drivers of this gap remain inadequately categorized. Objective: To determine the prevalence of therapeutic inertia and establish the patient-related, behavioral, and structural health-system factors associated with the management of hyperglycaemia among T2DM patients receiving care at MRRH. Methods and Materials: A facility-based, cross-sectional analytical study was conducted among n = 421 adult T2DM patients sampled from the outpatient diabetes clinic as well as medical and surgical wards at MRRH. Quantitative data were gathered utilizing structured interviewer-administered questionnaires alongside extensive clinical record audits. Glycaemic control was classified via Fasting Blood Sugar (FBS) thresholds. Data processing and statistical computations were executed using Stata 17.0, utilizing descriptive statistics and bivariate Chi-square (chi^2) analysis to identify significant parameters (p < 0.05). Results: The cohort exhibited a mean age of 45.15, 12.61 years, with a female majority (65.08%) and high prevalence of non-formal employment (91.65%). Uncontrolled hyperglycaemia (FBS > 7.0 mmol/L) was documented in 44.42% (n = 187) of participants. The overall prevalence of therapeutic inertia was critically elevated at 93.58%, where 175 out of 187 metabolically unmitigated patients received no pharmacological up-titration or agent additions. Bivariate analysis revealed no statistically significant associations between poor glycaemic control and socio-demographic indicators, hospital distance, or annual clinic attendance rates (p > 0.05). Conversely, uncontrolled hyperglycaemia was significantly tied to composite behavioral non-adherence (p = 0.002), especially when driven by multi-layered barriers including forgetfulness, drug side effects, and stock-outs (66.67% uncontrolled) or fear of hypoglycemia (100% uncontrolled). Systemic institutional bottlenecks were highly pervasive: 72.45% experienced outpatient waiting times exceeding 2 hours, 66.67% lacked self-monitoring access, and hospital pharmacy anti-diabetic drug supplies were fully stable in only 45.61% of cases. Conclusion: Therapeutic inertia is highly endemic at MRRH, affecting nearly 94% of poorly managed T2DM cases. Notably, this care gap is not driven by client absenteeism or demographic disparities, as 93.82% of patients comply perfectly with monthly follow-up schedules. Instead, it is perpetuated by a clinical environment favoring passive tracking over active clinical management. Resolving this clinical inertia requires moving beyond patient blame to implement structural institutional changes: embedding point-of-care diagnostic infrastructure, deploying standardized algorithmic intensification protocols, optimizing outpatient workflows to combat prolonged wait times, and securing an uninterrupted pharmacy supply chain. | |
| dc.description.sponsorship | Sr. Lydia Ssenyonga ; Mr. Olowo Samuel ; Busitema University. | |
| dc.identifier.citation | Mulomi, I. (2026). Factors associated with therapeutic inertia in treatment of hyperglycaemia in patients with type two diabetes at Mbale regional referral hospital. [Unpublished undergraduate research report]. Busitema University. | |
| dc.identifier.uri | https://bdears.busitema.ac.ug/handle/123456789/8412 | |
| dc.language.iso | en | |
| dc.publisher | Busitema University | |
| dc.title | Factors associated with therapeutic Inertia in treatment of hyperglycaemia in patients with type two diabetes at Mbale regional referral hospital. | |
| dc.type | Other |