Is deep vein thrombosis prophylaxis appropriate in the medical wards? A clinical pharmacists’ intervention study

Khalili, Hossein; Dashti‐Khavidaki, Simin; Talasaz, Azita Hajhossein; Mahmoudi, Laleh; Eslami, Kaveh; Tabeefar, Hamed

doi:10.1007/s11096-010-9412-y

Cited by 14 publications

(32 citation statements)

References 30 publications

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“…We show that pharmacist-driven interventions increased the proportion of at risk patient receiving VTE prophylaxis according to explicit clinical recommendations based on international guidelines in an academic hospital with a lot of physicians in training, an important turnover of physicians and nurses, and no electronic prescription available. This result confirms other studies conducted in other setting and showing that pharmacist-led programs for VTE prevention was associated with a significant increase in the prescribing of VTE prophylaxis [14][15][16][17][18]. Different interventions and tools may help physicians change their practice.…”

Section: Discussionsupporting

confidence: 88%

Improved venous thromboembolism prophylaxis by pharmacist-driven interventions in acutely ill medical patients in Belgium

2014

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Section: Discussionsupporting

confidence: 88%

Improved venous thromboembolism prophylaxis by pharmacist-driven interventions in acutely ill medical patients in Belgium

2014

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“…In a study that was carried out in Iran, clinical pharmacists’ interventions could improve DVT prophylaxis, as an untreated indication. [40]…”

Section: Discussionmentioning

confidence: 99%

Clinical pharmacy services in an Iranian teaching hospital: Type, severity, resolution, and accuracy

et al. 2013

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Objective:Clinical pharmacy services are improving in hospitals. For assessing the impact of these services, first it is important to exactly describe them by categorizing into types, severity, resolution, and accuracy. The objective of this study is to provide a detailed analysis of the clinical pharmacists’ services performed on in-patients in a teaching hospital during 28 months. Setting: Masih Daneshvari hospital, Tehran, Iran.Methods:This is a descriptive study. The authors retrospectively reviewed the notes of all services and entered them in a designed SPSS sheet. Documentation was carried out based on the “findings, assessment, resolution, and monitoring” method. The data were descriptively analyzed. Main outcome measure: Types, subtypes, severities, resolutions, and accuracies of services were defined, documented, and analyzed.Findings:In total 3152 records (2227 interventions and 925 visits with no intervention) were classified and analyzed in this study. Among all types of interventions, “improper medication use” (36.2%) was the most frequent intervention and among categories (subgroups) of “improper medication use,” “untreated indication” was the most frequent (23.7%). From the aspect of severity, 75.4% of interventions were estimated as of minor potential inconvenience to the patient (severity degree 1). Most interventions (78%) were finally recommended to the prescriber and 97.6% of interventions were considered accurate on further evaluation.Conclusion:Clinical pharmacists’ interventions are highly demanded in the hospitals. Based on the results of this study, conditions needing medication to prevent later complications in the course of therapy are sometimes ignored, which emphasizes the positive role of the clinical pharmacists’ involvements in clinical teams to improve outcome.

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“…[111415] To determine the probability of VTE (0.1 for the medical patients, 0.4 for the surgical patients) and bleeding (0.01) as ADEs caused by inappropriate VTEP was also based on previous studies and published reports. [139161718]…”

Section: Methodsmentioning

confidence: 99%

“…This is a leading cause of mortality and morbidity in hospitalized patients. [123] Every year, over 25,000 people in England die from hospital-acquired VTE and it has become a huge health problem. [45] The total cost of managing VTE in the UK is approximately £640 million/year.…”

Section: Introductionmentioning

confidence: 99%

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Developing an economic case of clinical pharmacists' interventions on venous thromboembolism prophylaxis through service evaluation

2017

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Objective:Venous thromboembolism (VTE) has become a huge health problem as well as a financial burden for the National Health Service. The objective of this study was to characterize current practice of VTE prophylaxis (VTEP) and evaluate the economic impact of clinical pharmacists’ interventions (CPIs) on VTEP.Methods:A prospective service evaluation was conducted in a medical and surgical ward at a tertiary teaching hospital in London from 23 May to 08 June 2016. Appropriateness of risk assessment (RA) and VTEP and CPIs were categorized and assessed. Based on the results of the service evaluation, a pharmacoeconomic analysis was undertaken to estimate the cost savings by CPIs for inappropriate pharmacological VTEP.Findings:A total of 203 cases were analyzed. The rates of appropriateness for RA on admission, RA at 24 h and pharmacological VTEP were 58.6%, 39.7%, and 75.4%, respectively. In the medical ward, there was a significant difference of appropriate RAs between on admission and at 24 h (70.3% vs. 23.8%, respectively). Whereas, the rate of appropriate pharmacological VTEP accounted for 75.4% and the rate of appropriate prophylaxis was significantly higher in the medical ward than surgical ward (80.5% vs. 68.2%, P = 0.045). Of 50 cases of inappropriate pharmacological prophylaxis, 39 cases (78.0%) were corrected by clinical pharmacists. These CPIs resulted in £1,286.23 cost savings during the study and it was estimated to be £517,522/annum.Conclusion:CPIs had significant positive clinical and economic impacts on VTEP. There is more scope for the improvement of RA at 24 h through CPIs.

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Is deep vein thrombosis prophylaxis appropriate in the medical wards? A clinical pharmacists’ intervention study

Abstract: The implementation of clinical pharmacists' prepared protocol helped to a great extent in the improvement of administrating DVT prophylaxis appropriately in patients.

Cited by 14 publications

References 30 publications

Improved venous thromboembolism prophylaxis by pharmacist-driven interventions in acutely ill medical patients in Belgium

Improved venous thromboembolism prophylaxis by pharmacist-driven interventions in acutely ill medical patients in Belgium

Clinical pharmacy services in an Iranian teaching hospital: Type, severity, resolution, and accuracy

Developing an economic case of clinical pharmacists' interventions on venous thromboembolism prophylaxis through service evaluation

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