چکیده (انگلیسی):

Background:Prescribing that is not concordant with guidelines is increasingly referred to as clinical inertia (CI).
However, CI may be only apparent, and the absence of decision may actually reflect appropriate inaction as a result
of good clinical reasoning. Our study aimed to: (i) elucidate GPs’ beliefs regarding CI and the risk of CI in their own
practice, (ii) identify modifiable provider-related factors associated with CI.
Methods:We conducted 8 group interviews with 114 general practitioners (GP) in Belgium, and used an integrated
approach of thematic analysis.
Results:Our results call for a redefinition of CI, in order to take into account the GPs’ extended health-promoting
role, and acknowledge that inaction or delayed action follows a process of clinical reasoning that takes into account
the patients’ preferences, and that is appropriate most of the time. However, the participants in our study did
acknowledge that the risk of CI exists in practice. The main factor of such a risk is when GPs feel overwhelmed
and disempowered, due to characteristics of either the patients or the health care system, including contradictions
between guidelines and reimbursement policies.
Conclusions:Although situations of clinical inertia exist in practice and need to be prevented or corrected, the
term clinical inertia could potentially increase the already existing gap between general practice and specialised
care, whereas sustained efforts toward more collaborative work and integrated care are called for