ADA 2026: Pharmacist CE Programs May Reduce Clinical Inertia in Type 2 Diabetes

Despite the availability of effective therapies and evidence-based guidelines, clinical inertia remains a major obstacle to optimal management of type 2 diabetes (T2D). Emerging data presented at the 2026 American Diabetes Association (ADA) Scientific Sessions in New Orleans, Louisiana, highlight the real-world barriers pharmacists encounter when supporting treatment intensification and suggest that targeted continuing education (CE) programs may improve pharmacists' confidence and competence in addressing therapeutic delays.¹

Poster Findings: Patient and Access Challenges Drive Clinical Inertia

The researchers conducted a pharmacist-focused educational outcomes study in order to characterize barriers that contribute to clinical inertia in T2D and evaluate the impact of a targeted CE program on pharmacist confidence and competence. Local professional organizations helped recruit hospital and ambulatory care pharmacists to participate in 11 live educational programs and a webinar.¹

Prior to the educational intervention, the participants completed an 8-question survey assessing confidence in therapy intensification, application of diabetes guidelines, and patient counseling. The survey also explored perceived barriers to treatment selection and factors contributing to delays in therapy escalation.¹

Amongst the 650 pharmacists who completed the pre-program survey, insurance and medication access issues emerged as the most frequently reported challenge, cited by 41% of respondents. Patient adherence and lifestyle-related factors followed closely, identified by 37% of pharmacists as significant obstacles to diabetes management.¹

When asked specifically about contributors to delays in therapy intensification, pharmacists most frequently identified patient-related barriers, including competing life priorities, medication costs, and limited health literacy. These factors were cited by 41% of respondents. Additionally, uncertainty regarding therapy sequencing was recognized as a barrier to timely treatment advancement, highlighting ongoing challenges associated with navigating an increasingly complex diabetes treatment landscape.¹

Following the educational intervention, 900 pharmacists completed post-program assessments. Investigators reported consistent improvements in both confidence and competence related to identifying clinical inertia and implementing guideline-directed treatment strategies. Participants also reported intentions to adopt practice changes, including earlier use of guideline-recommended therapies and pharmacist-driven approaches designed to reduce therapeutic inertia.¹

The Persistent Challenge of Clinical Inertia in T2D

Clinical inertia is commonly defined as the failure to initiate or intensify therapy when treatment goals are not achieved. Although advances in diabetes management have expanded therapeutic options, delays in treatment adjustment remain common and can contribute to prolonged hyperglycemia and increased risk of diabetes-related complications.²

Multiple factors contribute to clinical inertia; this includes patient-to-provider and system-level barriers. Prior data has identified medication costs, insurance restrictions, treatment complexity, concerns about adverse effects, competing patient priorities, and limited health literacy as common contributors to delayed treatment escalation.^3-5

The growing number of available glucose-lowering agents, including glucagon-like peptide-1 (GLP-1) receptor agonists, dual incretin therapies, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and insulin formulations, has also increased the complexity of treatment selection. As a result, clinicians may experience uncertainty regarding therapy sequencing and intensification strategies, particularly when balancing glycemic control with cardiovascular, renal, and weight-management considerations.⁶

Pharmacists are increasingly positioned to address these challenges through medication management, patient education, adherence support, and collaborative practice models that facilitate evidence-based treatment optimization.⁷

Educational Interventions and the Pharmacist's Role

The findings from this study suggest that implementation-focused education may help pharmacists overcome knowledge gaps and increase confidence in addressing clinical inertia. By emphasizing case-based learning and practical application of guideline-directed care, CE programs may equip pharmacists with strategies to recognize delays in treatment escalation and intervene more effectively.¹

This educational approach is particularly relevant as pharmacists assume expanding roles in chronic disease management. In ambulatory care settings, pharmacists routinely assist with medication selection, prior authorizations, patient counseling, and adherence monitoring, all of which can influence the timeliness of treatment intensification.⁷

The data findings further reinforce the importance of comprehending the nonclinical factors that influence diabetes care. Insurance coverage limitations, medication affordability, and social determinants of health may present significant barriers even when effective therapies are available. Identifying and addressing these obstacles can help pharmacists facilitate access to appropriate treatments and support achievement of glycemic goals.^3-5

Clinical Practice and Pharmacy Implications

With the rise of prevalence in T2D, strategies that reduce therapeutic delays will become increasingly important. The ADA 2026 findings indicate that pharmacists recognize numerous real-world barriers to treatment intensification, with patient-related factors and access challenges emerging as the most common contributors to clinical inertia.¹

Most critically, the data demonstrated that targeted educational interventions may improve pharmacists' confidence and competence in identifying and addressing these barriers. Participants reported intentions to implement earlier guideline-directed therapy use and pharmacist-led approaches to support timely treatment escalation.¹

REFERENCES

1. Isaacs D, Buszka F, Winters B, Brixie M. Real-World Barriers Contributing to Clinical Inertia in Type 2 Diabetes: A Pharmacist-Focused Educational Outcomes Study. Poster presented at: 2026 American Diabetes Association Scientific Sessions, June 5-8, 2026. New Orleans, LA. Accessed via the Online ADA Scientific Sessions Platform.

2. Okemah J, Peng J, Quiñones M, et al. Addressing clinical inertia in type 2 diabetes mellitus: a review. Adv Ther. 2018;35:1735–1745. doi:10.1007/s12325-018-0819-5

3. Seo HS, Kim HW, Roh DH, et al. A new rat model for thrombus-induced ischemic pain (TIIP); development of bilateral mechanical allodynia. Pain. 2008;139(3):520-532. doi:10.1016/j.pain.2008.06.011

4. Paul SK, Klein K, Thorsted BL, et al. Delay in treatment intensification increases the risks of cardiovascular events in patients with type 2 diabetes. Cardiovasc Diabetol 2015;14:100. doi:10.1186/s12933-015-0260-x

5. American Diabetes Association Professional Practice Committee. Improving Care and Promoting Health in Populations: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S13-S26. doi:10.2337/dc26-S001

6. Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in Type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753–2786. doi:10.2337/dci22-0034

7. Greer N, Bolduc J, Geurkink E, et al. Pharmacist-Led Chronic Disease Management: A Systematic Review of Effectiveness and Harms Compared With Usual Care. Ann Intern Med. 2016;165(1):30-40. doi:10.7326/M15-3058