Clinical Inertia in Physiotherapy: What is it, and How Can it be Addressed?

Abstract

Health professionals are expected to exercise due diligence in patient care and to practise based on evidence and document services and discharge  care comprehensively and concisely. This paper elucidated the phenomenon of clinical inertia; it sought to generate interest and awareness on the  phenomenon, as well to facilitate reflections on patient management practices. PubMed was searched using the terms ‘clinical inertia’, ‘clinical  auditing’ and ‘physiotherapy’. The abstracts of the search endeavour, containing 159 articles, were all reviewed for content relevance. Twenty-two  articles were finally selected but only ten were published within the last five years. These were analysed and synthesised and made obtainable. The  review identified true clinical inertia and differentiated it from apparent inertia which may reflect good judgement in clinical practice. Provider-,  patientand system-related factors were highlighted as contributors to clinical inertia. Providerrelated factors identified included overestimation of  the care offered by providers, use of ‘soft’ reason to avoid providing therapy and lack of training, education or organisation to achieve therapeutic  goals. Patient-related factors identified were related to patients’ health, belief model, health literacy, self-efficacy and adherence to instructions,  while systemrelated factors included availability of resources. Clinical inertia in physiotherapy was exemplified and the possible risk, rampancy or  pervasive nature of therapeutic inertia among practitioners of physiotherapy in Nigeria was highlighted. This explorative review also offered insights  into how clinical inertia could be addressed among physiotherapy clinicians in Nigeria.