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Improved utilisation of venous thromboembolism prophylaxis in renal-impaired patients following a clinical pharmacist intervention
  1. Naemeh Nikvarz1,
  2. Zahra Seyedi2
  1. 1Herbal and Traditional Medicines Research Center and Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
  2. 2Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of)
  1. Correspondence to Dr Naemeh Nikvarz, Herbal and Traditional Medicines Research Center and Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences, Kerman University of Medical Sciences, Kerman, Iran (the Islamic Republic of); nnikvarz{at}kmu.ac.ir

Abstract

Objectives To evaluate the role of the clinical pharmacist in improving venous thromboembolism (VTE) prophylaxis prescription in patients with renal impairment (RI).

Methods This was an interventional cross-sectional study conducted in a nephrology ward. Patients’ risk scores for VTE and bleeding during hospitalisation (evaluated by the Caprini Risk Assessment Model (RAM), Padua Prediction Score and IMPROVE Bleeding Risk Score, respectively), and the rate of VTE prophylaxis administration to patients, were evaluated before and after a clinical pharmacist’s intervention.

Results In the pre-intervention phase, 34.8% of high-VTE-risk patients, of whom 12.5% were also at high risk of bleeding, received pharmacological prophylaxis. Moreover, 22.2% of low-VTE-risk patients received prophylaxis. In the intervention phase, prophylaxis was administered to all high-risk patients (mechanical prophylaxis in 7% of patients with a high risk of both VTE and bleeding, and heparin in the remainder) and to 3.3% of those at low risk of VTE.

Conclusions The clinical pharmacist’s intervention using RAMs can improve the rate of thrombosis prophylaxis prescription in patients with RI who have a high risk of VTE.

  • thromboembolism
  • hemorrhage
  • renal impairment
  • clinical pharmacist
  • risk assessment models
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