Use of venous thromboprophylaxis and adherence to guideline recommendations: a cross-sectional study

Vallano, Antonio; Arnau, Josep Maria; Miralda, Gaietà Permanyer; Pérez-Bartolí, Jaume

doi:10.1186/1477-9560-2-3

Cited by 43 publications

(14 citation statements)

References 31 publications

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“…In several studies, prophylactic therapy showed 13-79% compliance with the standard treatment guidelines [1,4,10,12,17,18]. The results of the present study showed 83.3% compliance with ACCP guidelines.…”

Section: Discussionsupporting

confidence: 68%

“…Appropriate prophylaxis management can reduce the cost of treatment, duration of hospital stay, and the rate of side effects [6,10]. Despite the existence of many different guidelines, adequate thromboprophylaxis is not being correctly prescribed: high-risk patients are under-treated and low-risk patients are over-treated [17].…”

Section: Discussionmentioning

confidence: 99%

“…High levels of agreement with the guidelines in some studies may be due to the investigation of the patients with high risk of VTE, such as the patients hospitalized in surgical and intensive care units [10,[17][18][19][20]. For example in the study by Vallano et al [10], the rates of prophylaxis compliance with the standard treatment guidelines were 85.2% at at surgery, 90.9% at ICU, 62.5% at emergency, and 69.9% at general wards. Nevertheless, in the present study, no significant difference was observed among the three wards regarding the rate of compliance.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, Consensus Conferences and Guidelines for VTE prophylaxis have been published recommending the use of prophylactic unfractionated heparin (UFH) or low molecular weight heparin (LMWH) such as enoxaparin in the patients who are at risk of VTE [8][9][10]. According to these guidelines, the use of anticoagulants can reduce the adverse events of VTE as well as the healthcare costs [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…According to these guidelines, the use of anticoagulants can reduce the adverse events of VTE as well as the healthcare costs [3][4][5]. In spite of this scientific evidence, several studies [6,[10][11][12][13][14] have shown low efficiency and improper use of prophylaxis. Up to now, a few studies such as the study by Khalili et al [4] have been conducted to compare the compatibility of the prophylaxis methods for VTE with the standard treatment guidelines in Iran.…”

Section: Introductionmentioning

confidence: 99%

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Monitoring of Thromboembolic Events Prophylaxis: Where Do We Stand?

Mahmoudi¹,

Namazi²,

Nemati³

et al. 2015

J Hematol

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Background: Thromboembolic events are one of the most important causes of mortality in the hospitalized patients. Evaluation of anticoagulants intake patterns compared to the standard treatment guidelines is necessary for improving the quality of prophylaxis managements. The present study was performed to evaluate the pattern of heparin and enoxaparin intake compared to the standard treatment guidelines for thromboprophylaxis.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Monitoring of Thromboembolic Events Prophylaxis: Where Do We Stand?

Mahmoudi¹,

Namazi²,

Nemati³

et al. 2015

J Hematol

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Interventions for implementation of thromboprophylaxis in hospitalized medical and surgical patients at risk for venous thromboembolism

Kahn

Morrison

Cohen

et al. 2013

Cochrane Database of Systematic Reviews

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Improved use of thromboprophylaxis for deep vein thrombosis following an educational intervention

Cohn

Adekile

Mahabir

2006

Journal of Hospital Medicine

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BACKGROUND:We evaluated venous thromboembolism (VTE) prophylaxis rates in hospitalized medical patients in a teaching hospital, the State University of New York-Downstate Medical Center-University Hospital of Brooklyn, before and after implementation of a multifaceted VTE prophylaxis quality improvement intervention that combined regular education, dissemination of a decision support tool, and regular audit-and-feedback to resident physicians. METHODS:The charts of 312 hospitalized medical patients were retrospectively reviewed to assess baseline rates of appropriate VTE prophylaxis. Rates of appropriate VTE prophylaxis were then determined 12 and 18 months after implementation of the quality improvement intervention. Data collected included risk factors for VTE, contraindications to anticoagulant prophylaxis, type of VTE prophylaxis prescribed, and whether the prophylaxis was appropriate. RESULTS:Most of the hospitalized medically ill patients had 3 or more risk factors for VTE. At baseline, the proportion of patients receiving any form of VTE prophylaxis, primarily unfractionated heparin, was 47%. The proportion of patients for whom a physician provided appropriate prophylaxis was 43%. After the intervention, the proportion of patients receiving prophylaxis significantly increased, to 86% at 12 months, and this level was maintained at 18 months. The rate of appropriate prophylaxis increased to 68% and 85% after 12 and 18 months, respectively. V enous thromboembolism (VTE), which encompasses both deep vein thrombosis (DVT) and pulmonary embolism (PE), is a major cause of the morbidity and mortality of hospitalized medical patients. CONCLUSIONS:1 Hospitalization for an acute medical illness has been associated with an 8-fold increase in the relative risk of VTE and is responsible for approximately a quarter of all VTE cases in the general population. 2,3Current evidence-based guidelines, including those from the American College of Chest Physicians (ACCP), recommend prophylaxis with low-dose unfractionated heparin (UFH) or lowmolecular-weight heparin (LMWH) for medical patients with risk factors for VTE. 4,5 Mechanical prophylaxis methods including graduated compression stockings and intermittent pneumatic compression are recommended for those patients for whom an- O R I G I N A L R E S E A R C H 331ticoagulant therapy is contraindicated because of a high risk of bleeding. 4,5 However, several studies have shown that adherence to these guidelines is suboptimal, with many at-risk patients receiving inadequate prophylaxis (range 32%-87%). 6 -10 Physician-related factors identified as potential barriers to guideline adherence include not being aware or familiar with the guidelines, not agreeing with the guidelines, or believing the guideline recommendations to be ineffective. 11 More specific studies have shown that some physicians may lack basic knowledge regarding the current treatment standards for VTE and may underestimate the significance of VTE.12-13 As distinct strategies, education aimed at disseminatin...

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Use of venous thromboprophylaxis and adherence to guideline recommendations: a cross-sectional study

Cited by 43 publications

References 31 publications

Monitoring of Thromboembolic Events Prophylaxis: Where Do We Stand?

Monitoring of Thromboembolic Events Prophylaxis: Where Do We Stand?

Interventions for implementation of thromboprophylaxis in hospitalized medical and surgical patients at risk for venous thromboembolism

Improved use of thromboprophylaxis for deep vein thrombosis following an educational intervention

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