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Effect of a Clinical Pharmacy Education Program on Improvement in the Quantity and Quality of Venous Thromboembolism Prophylaxis for Medically Ill Patients

OBJECTIVES: The American College of Chest Physicians (ACCP) recommends unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) for prevention of venous thromboembolism (VTE) in medically ill patients. Despite these recommendations, a previous analysis at our institution revealed a low ut...

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Autores principales: Dobesh, Paul P., Stacy, Zachary A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Academy of Managed Care Pharmacy 2005
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437579/
https://www.ncbi.nlm.nih.gov/pubmed/16300419
http://dx.doi.org/10.18553/jmcp.2005.11.9.755
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author Dobesh, Paul P.
Stacy, Zachary A.
author_facet Dobesh, Paul P.
Stacy, Zachary A.
author_sort Dobesh, Paul P.
collection PubMed
description OBJECTIVES: The American College of Chest Physicians (ACCP) recommends unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) for prevention of venous thromboembolism (VTE) in medically ill patients. Despite these recommendations, a previous analysis at our institution revealed a low utilization of VTE prophylaxis in medically ill patients. Our objective was to evaluate the effects of a pharmacy-driven education program on the quantity and quality of VTE prophylaxis in medically ill patients. METHODS: An educational program focusing on the importance of VTE prophylaxis in medically ill patients was developed by clinical pharmacists and presented to nurses, pharmacists, and physicians in a 493-bed community teaching hospital. The educational program was conducted between June 2002 and June 2003 and consisted of in-service presentations, newsletters, and quality assurance presentations on VTE prophylaxis. The educational program focused on 4 main points: (1) hospitalized medically ill patients are at risk for developing VTE, (2) how to identify medically ill patients who require VTE prophylaxis, (3) the fact that VTE prophylaxis is currently underutilized in medically ill patients, and (4) appropriate VTE prophylaxis strategies for medically ill patients. A posteducation retrospective chart review was performed in medically ill patients with discharge dates between October 2003 and March 2004, and these posteducation medical chart data were compared with the results from a preeducation analysis of patents with discharge dates from January 2001 to March 2002. Data collection included patient demographics, VTE risk factors, and use and type of VTE prophylaxis. RESULTS: The posteducation retrospective chart review was performed for 297 medically ill patients with discharge dates between October 2003 and March 2004 and for 344 preeducation patients discharged between January 2001 and March 2002. Patient demographics and primary diagnoses were similar between the preeducation and posteducation groups. The mean number of risk factors per patient in the preeducation group was 2.53 ± 0.96 versus 2.38 ± 0.88 in the posteducation group (P=0.626). Pharmacy education was associated with an increase in the utilization of any VTE prophylaxis (43% in the preperiod vs. 58% in the postperiod; P less than 0.001). Prophylaxis judged to be suitable (UFH 5,000 units twice daily, or UFH 5,000 units 3 times daily, or LMWH once daily), increased from 38% in the preeducation period to 49% in the posteducation period, P=0.006). Prophylaxis judged to be optimal (UFH 3 times daily or LMWH once daily) increased from 11% to 44% of patients, P less than 0.001). CONCLUSIONS: A hospital-wide clinical pharmacy education program was associated with significant improvement in the quantity and quality of VTE prophylaxis in medically ill patients in a community teaching hospital.
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spelling pubmed-104375792023-08-21 Effect of a Clinical Pharmacy Education Program on Improvement in the Quantity and Quality of Venous Thromboembolism Prophylaxis for Medically Ill Patients Dobesh, Paul P. Stacy, Zachary A. J Manag Care Pharm Contemporary Subject OBJECTIVES: The American College of Chest Physicians (ACCP) recommends unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) for prevention of venous thromboembolism (VTE) in medically ill patients. Despite these recommendations, a previous analysis at our institution revealed a low utilization of VTE prophylaxis in medically ill patients. Our objective was to evaluate the effects of a pharmacy-driven education program on the quantity and quality of VTE prophylaxis in medically ill patients. METHODS: An educational program focusing on the importance of VTE prophylaxis in medically ill patients was developed by clinical pharmacists and presented to nurses, pharmacists, and physicians in a 493-bed community teaching hospital. The educational program was conducted between June 2002 and June 2003 and consisted of in-service presentations, newsletters, and quality assurance presentations on VTE prophylaxis. The educational program focused on 4 main points: (1) hospitalized medically ill patients are at risk for developing VTE, (2) how to identify medically ill patients who require VTE prophylaxis, (3) the fact that VTE prophylaxis is currently underutilized in medically ill patients, and (4) appropriate VTE prophylaxis strategies for medically ill patients. A posteducation retrospective chart review was performed in medically ill patients with discharge dates between October 2003 and March 2004, and these posteducation medical chart data were compared with the results from a preeducation analysis of patents with discharge dates from January 2001 to March 2002. Data collection included patient demographics, VTE risk factors, and use and type of VTE prophylaxis. RESULTS: The posteducation retrospective chart review was performed for 297 medically ill patients with discharge dates between October 2003 and March 2004 and for 344 preeducation patients discharged between January 2001 and March 2002. Patient demographics and primary diagnoses were similar between the preeducation and posteducation groups. The mean number of risk factors per patient in the preeducation group was 2.53 ± 0.96 versus 2.38 ± 0.88 in the posteducation group (P=0.626). Pharmacy education was associated with an increase in the utilization of any VTE prophylaxis (43% in the preperiod vs. 58% in the postperiod; P less than 0.001). Prophylaxis judged to be suitable (UFH 5,000 units twice daily, or UFH 5,000 units 3 times daily, or LMWH once daily), increased from 38% in the preeducation period to 49% in the posteducation period, P=0.006). Prophylaxis judged to be optimal (UFH 3 times daily or LMWH once daily) increased from 11% to 44% of patients, P less than 0.001). CONCLUSIONS: A hospital-wide clinical pharmacy education program was associated with significant improvement in the quantity and quality of VTE prophylaxis in medically ill patients in a community teaching hospital. Academy of Managed Care Pharmacy 2005-11 /pmc/articles/PMC10437579/ /pubmed/16300419 http://dx.doi.org/10.18553/jmcp.2005.11.9.755 Text en Copyright © 2005, Academy of Managed Care Pharmacy. All rights reserved. https://creativecommons.org/licenses/by/4.0/This article is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use and redistribution provided that the original author and source are credited.
spellingShingle Contemporary Subject
Dobesh, Paul P.
Stacy, Zachary A.
Effect of a Clinical Pharmacy Education Program on Improvement in the Quantity and Quality of Venous Thromboembolism Prophylaxis for Medically Ill Patients
title Effect of a Clinical Pharmacy Education Program on Improvement in the Quantity and Quality of Venous Thromboembolism Prophylaxis for Medically Ill Patients
title_full Effect of a Clinical Pharmacy Education Program on Improvement in the Quantity and Quality of Venous Thromboembolism Prophylaxis for Medically Ill Patients
title_fullStr Effect of a Clinical Pharmacy Education Program on Improvement in the Quantity and Quality of Venous Thromboembolism Prophylaxis for Medically Ill Patients
title_full_unstemmed Effect of a Clinical Pharmacy Education Program on Improvement in the Quantity and Quality of Venous Thromboembolism Prophylaxis for Medically Ill Patients
title_short Effect of a Clinical Pharmacy Education Program on Improvement in the Quantity and Quality of Venous Thromboembolism Prophylaxis for Medically Ill Patients
title_sort effect of a clinical pharmacy education program on improvement in the quantity and quality of venous thromboembolism prophylaxis for medically ill patients
topic Contemporary Subject
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10437579/
https://www.ncbi.nlm.nih.gov/pubmed/16300419
http://dx.doi.org/10.18553/jmcp.2005.11.9.755
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