Clinical Outcome and Cost of Hospital vs Home Treatment of Proximal Deep Vein Thrombosis With a Low-Molecular-Weight Heparin

Boccalón, H; Elias, Antoine; Chalé, Jean-Jacques; Cadène, A; Gabriel, Sylvie

doi:10.1001/archinte.160.12.1769

Cited by 104 publications

(75 citation statements)

References 18 publications

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“…These studies focused on a wide variety of settings and management strategies, such as prospective outpatient management of recurrent thromboembolism events (100, 125, and 107 patients) [29][30][31] ; randomized, multicenter trials 16,32,33 ; decision modeling approaches 16,18 ; and home-oriented pharmacy management. 34 Two observational studies focused on detailing DVT costs of care from the MCO perspective over the first 90 days: (1) a prospective study inside a group-model HMO 35 and (2) a retrospective study conducted in a staff-model HMO.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Evaluation of Health Plan Cost per Venous Thromboembolism or Bleed Event in Patients With a Prior Venous Thromboembolism Event During Hospitalization

Bullano¹,

Willey²,

Hauch³

et al. 2005

JMCP

113

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Section: Discussionmentioning

confidence: 99%

Longitudinal Evaluation of Health Plan Cost per Venous Thromboembolism or Bleed Event in Patients With a Prior Venous Thromboembolism Event During Hospitalization

Bullano¹,

Willey²,

Hauch³

et al. 2005

JMCP

113

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“…The pharmacokinetic and pharmacodynamic particularities, such as high bioavailability, long half-life, more predictable anticoagulant response, easy laboratory monitoring and less bleeding risk in comparison with unfractionated heparin contribute to the widespread use of LMWH in the hospital and home-care contexts [2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

Subcutaneous administration technique of low-molecular-weight heparins: An integrative review

Campos¹,

Silva

Beck

et al. 2013

Clinical Nursing Studies

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Anti-coagulant drugs for subcutaneous injection, like low-molecular-weight heparins (LMWH), are increasingly used to prevent and treat thromboembolic events, with local adverse reactions. The aim in this integrative review was to identify and analyze knowledge production about the most appropriate SC injection technique of LMWH to reduce hematomas, bruising and local pain. The following inclusion criteria were used: papers published in English, Spanish and Portuguese; between the first week of August 2001 and the last week of August 2012. Papers in which LMWH was compared with unfractionated heparin in the assessment of the outcomes and papers without statistical data analysis were excluded. The searches were undertaken in the electronic databases PubMed/MedLine, CINAHL, Scopus, Web of Science and LILACS/IBECS. The quality of the articles was assessed with the critical appraisal tool JBI MAStARI. The incidence of bruising ranged between 20%, when the application time of the injection was 30s, and 88.9% when it took 10s. In 50% of the studies, the authors concluded that LMWH injections taking 30s caused lower levels of bruising, with statistically significant differences, as well as a reduction in pain intensity in the injection site by up to 50%. The group that received LMWH through a prefilled syringe, with or without aspiration, showed lower levels of bruising. The formation of a skinfold, the 90º angle and the abdomen as the application site have been well documented in the literature. These findings are important for clinical nursing practice, as they found the elaboration of evidence-based care protocols and contribute to the improvement of patient care quality.

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“…10 Moreover, studies comparing outpatient and inpatient treatment with LMWHs have shown that outpatient treatment can result in cost savings of up to 82%. 11,19 Lee et al reported in 1996 that the outpatient treatment of DVT with LMWH reduced the mean patient treatment cost from $3,266 to $584, a cost that included medications, laboratory analyses, and home visits or hospital days as appropriate. 11 Tillman et al found that an outpatient program carried out in a health maintenance organization, enrolling 391 patients treated with initial enoxaparin and warfarin to 90 days, realized total cost savings of $1,108,587 over the 2-year evaluation period.…”

Section: Ss Discussionmentioning

confidence: 99%

A Pilot Study of Home Treatment of Deep Vein Thrombosis With Subcutaneous Once-Daily Enoxaparin Plus Warfarin

Bishop¹,

Wilson²,

Post³

et al. 2006

JMCP

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Clinical Outcome and Cost of Hospital vs Home Treatment of Proximal Deep Vein Thrombosis With a Low-Molecular-Weight Heparin

Abstract: Background: Low-molecular-weight heparins have been shown to be effective and safe in the treatment of deep vein thrombosis. To our knowledge, there have been no direct comparisons of such treatment on an outpatient vs an inpatient basis.

Cited by 104 publications

References 18 publications

Longitudinal Evaluation of Health Plan Cost per Venous Thromboembolism or Bleed Event in Patients With a Prior Venous Thromboembolism Event During Hospitalization

Longitudinal Evaluation of Health Plan Cost per Venous Thromboembolism or Bleed Event in Patients With a Prior Venous Thromboembolism Event During Hospitalization

Subcutaneous administration technique of low-molecular-weight heparins: An integrative review

A Pilot Study of Home Treatment of Deep Vein Thrombosis With Subcutaneous Once-Daily Enoxaparin Plus Warfarin

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