The Use of DVT prophylaxis in relation to patient risk profiling – TUNE-IN Study

Wessels, Philippus L.; Riback, Wayne

doi:10.7196/samj.4859

Cited by 8 publications

(9 citation statements)

References 2 publications

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“…2 For South Africa, the risk of VTE development during 2008 in hospitalised patients from parts of its Gauteng province was described to be at 74.6%, with venous thromboembolic-related deaths reported at around 20 000 persons annually in 2012. 3,4 A lack of updated data currently exists, and because most VTE symptoms remain undetected, the true VTE incidence together with its possible impact on the South African (SA) private healthcare system largely remains unknown. 5,6 Venous thromboembolic disease not only is debilitating but also presents a high economic burden on a country's healthcare system.…”

Section: Introductionmentioning

confidence: 99%

“…15,16,17,18 The SA arm of 'The Use of VTE prophylaxis in relatioN to patiEnt risk profiling' (TUNE-IN) study found that only 67.9% of patients rated as possessing a high risk for VTE development received appropriate prophylaxis. 3 Interestingly, it is reported that the main reason for reduced prophylactic prescribing is prescribers' perception that patients have a decreased risk for VTE development compared to available epidemiological data. 3 A large discrepancy often exists in the perceived VTE development risk amongst patients clinically appraised versus those in whom a standardised risk assessment model (RAM) was completed.…”

Section: Introductionmentioning

confidence: 99%

“…3 Interestingly, it is reported that the main reason for reduced prophylactic prescribing is prescribers' perception that patients have a decreased risk for VTE development compared to available epidemiological data. 3 A large discrepancy often exists in the perceived VTE development risk amongst patients clinically appraised versus those in whom a standardised risk assessment model (RAM) was completed. 3 Risk assessment models are traditionally designed to select patients in whom VTE prophylaxis benefit would outweigh the risk.…”

Section: Introductionmentioning

confidence: 99%

“…3 A large discrepancy often exists in the perceived VTE development risk amongst patients clinically appraised versus those in whom a standardised risk assessment model (RAM) was completed. 3 Risk assessment models are traditionally designed to select patients in whom VTE prophylaxis benefit would outweigh the risk. 3 Several reviews exist on the different available RAMs' ability to predict VTE development; however, no consensus has been reached on a preferred model.…”

Section: Introductionmentioning

confidence: 99%

“…3 Risk assessment models are traditionally designed to select patients in whom VTE prophylaxis benefit would outweigh the risk. 3 Several reviews exist on the different available RAMs' ability to predict VTE development; however, no consensus has been reached on a preferred model. 19,20 The American College of Chest Physicians' (ACCP) VTE prophylaxis guidelines are generally regarded as the gold standard to be followed, and Caprini devised a RAM to enable the easy implementation of these guidelines.…”

Section: Introductionmentioning

confidence: 99%

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Is guideline-driven prophylaxis for venous thromboembolism common practice in the South African private hospital setting?

2020

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Background: Prophylactic venous thromboembolism (VTE) strategies have the greatest impact on patient outcomes. Both global and local guidelines support VTE prophylaxis for hospitalised patients. However, studies have reported that these measures are routinely under-prescribed. This study evaluated prescribing patterns of VTE prophylaxis in one of the largest South African (SA) private hospital groups.Methods: A quantitative, retrospective analysis of the hospital group’s patient database was conducted for patients admitted between 01 September 2015 and 31 August 2016. Those younger than 18 years with trauma or suffering from contraindications to anticoagulation were excluded. Additionally, patients with warfarin billed were also excluded as they possibly required therapeutic anticoagulation. Included prophylactic measures were compared with published SA guidelines by abstracting prophylaxis type and dosing, according to corresponding individual patients’ VTE risk ratings.Results: Amongst the 373 020 patients included as the study population, 77% required prophylaxis. Of these, 38.36% (n = 85 486) received guideline-appropriate prophylactic measures during their hospital stay. Patients in whom prophylaxis was indicated, only 24.56% (n = 42 715) complied with the SA guidelines. The most commonly used prophylactic measures were enoxaparin (89.09%) and fondaparinux (2.68%). Prophylactic measures differed per speciality, with the most compliant amongst intensivists. A low uptake of the risk assessment model use (n = 222 860, 59.75%) was, however, reported for this data set.Conclusion: Less than 24.56% of patients who required prophylaxis received guideline-appropriate interventions. Further studies should focus on understanding differences in practice and improving acceptance and application of guideline-driven care.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is guideline-driven prophylaxis for venous thromboembolism common practice in the South African private hospital setting?

2020

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Deep Vein Thrombosis Prophylaxis in a Tertiary Care Center: An Observational Study

et al. 2016

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Background: Deep vein thrombosis (DVT) is a major health problem with substantial mortality and morbidity in medically ill patients. Prevention of DVT by risk factor stratification and subsequent antithrombotic prophylaxis in moderate-to severe-risk category patients is the most rational means of reducing morbidity and mortality.Objective: To study the management strategies for DVT prophylaxis in a tertiary care center and evaluate the prophylactic dosing patterns for DVT prevention.Methods: A prospective, observational study was performed in the intensive care units and medical wards of a tertiary care center. A structured proforma was designed for risk assessment and stratification of DVT in critically ill patients with recommended thromboprophylaxis. The dosing patterns of all medications given for DVT prophylaxis were analyzed for their appropriateness according to 8th ACCP guidelines.Results: A total of 480 patient charts were reviewed. It was observed that 358 patients (74.6%) were on mixed prophylaxis, 38 patients (18.5%) were on pharmacological prophylaxis, and 33 patients (6.9%) were on mechanical prophylaxis only. Enoxaparin and graduated compression stockings were the most commonly used pharmacological and mechanical prophylaxes, respectively. The prophylaxis guidelines were followed in 77% of the study population.The reasons for inappropriate dosing patterns were found to be subtherapeutic dosing and overdosing.Conclusions: Our study revealed that a higher proportion of the patients who are at high risk are currently given thromboprophylaxis as per the standard prophylactic recommendations. There is still considerable scope for improvement in the management of DVT in all

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The impact of risk assessment on the implementation of venous thromboembolism prophylaxis in foot and ankle surgery

Saragas

Ferrao

Saragas

et al. 2014

Foot and Ankle Surgery

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The Use of DVT prophylaxis in relation to patient risk profiling – TUNE-IN Study

Cited by 8 publications

References 2 publications

Is guideline-driven prophylaxis for venous thromboembolism common practice in the South African private hospital setting?

Is guideline-driven prophylaxis for venous thromboembolism common practice in the South African private hospital setting?

Deep Vein Thrombosis Prophylaxis in a Tertiary Care Center: An Observational Study

The impact of risk assessment on the implementation of venous thromboembolism prophylaxis in foot and ankle surgery

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