Background Forty to 50% of hospitalised patients with an acute medical illness have risk factors for venous thromboembolism (VTE) and it has been shown that thromboprophylaxis reduces the incidence of VTE events in these patients . However, a large multinational survey, the ENDORSE study, showed that only 37% of medical patients with VTE risk factors currently received thromboprophylaxis .
Purpose To evaluate the impact over time of pharmacist-driven interventions aiming at increasing the appropriate use of thromboprophylaxis in acutely ill medical patients hospitalised in an urban academic tertiary care hospital.
Materials and Methods First, medical and nurse reports of hospitalised medical patients were reviewed to evaluate the proportion of patients who were on prophylaxis according to clinical practise guidelines. Second, interventions were conducted and included unit-specific physician and nurse education, dissemination of educational tools summarising VTE prophylaxis guidelines, and reminders. Third, the effect of the interventions on the proportion of patients receiving appropriate thromboprophylaxis was evaluated after three and six months.
Results The baseline evaluation showed that 36% (26/72) of the patients at risk of VTE received appropriate thromboprophylaxis. Three and six months after the interventions, 68% (55/81), and 72% (58/81) of the patients at risk of VTE received appropriate thromboprophylaxis.
Of the patients not at risk of VTE, 15% (21/141), 8% (24/290), and 8% (27/330) respectively at baseline evaluation, three and six months after the interventions, received thromboprophylaxis.
Conclusions Pharmacist-driven interventions improved the proportion of acutely ill medical patients receiving appropriate thromboprophylaxis and the benefit of the interventions was maintained after six months.
Alikhan R et al, Blood Coagul Fibrinolysis, 2003;14:341–6.
Mahe I., Drugs & Aging, 2007, 24(1): 63–71
No conflict of interest.
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