Orv Hetil. 2026 Oct 25;167(43):1719-1729. doi: 10.1556/650.2026.33661. Print 2026 Oct 25.
ABSTRACT
Inertia refers to a lack of energy or helplessness; in the context of heart failure, clinical inertia can be understood primarily as the failure to initiate or optimize therapies known to reduce morbidity and mortality in patients not on optimized therapy. The aim of this review article is to provide an overview of the most recent guidelines and recommendations relevant to the topic, summarize the available international literature, and present the results of practical interventions that may also be feasibly implemented in Hungary. Heart failure remains a condition with an unfavorable prognosis; however, the use of modern, optimal, comprehensive, guideline-directed medical therapies may confer substantial prognostic benefit. In everyday clinical practice, clinical inertia is one of the main barriers to effective treatment, and the need to address it has also been emphasized in recent position statements of the European Society of Cardiology. The integration of multidisciplinary care, structured patient education, and targeted interventions is of fundamental importance in overcoming clinical inertia, optimizing treatment adherence, and improving long-term outcomes. Close follow-up and rapid up-titration of guideline-directed medical therapy in eligible patients are of particular importance and may significantly reduce the relative risk of heart failure hospitalization and all-cause mortality. The use of telemedicine during follow-up, together with the broader exploitation of digital opportunities, provides contemporary clinicians with a range of new possibilities. Based on real-world data, interventions that favorably influence clinical inertia can also be successfully implemented in Hungary, yielding significant clinical benefit for patients with heart failure. Orv Hetil. 2026; 167(43): 1719-1729.
PMID:42927501 | DOI:10.1556/650.2026.33661