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HEMATOLOGY

Venous Thromboembolism Prophylaxis in a South Australian Teaching Hospital

Pharmacy Intern, Repatriation General Hospital, Daw Park, South Australia

Christopher P Alderman, BPharm FSHP BCPP CGP

Associate Professor, Pharmacy Practice, Quality Use of Medicines and Pharmacy Research Centre, University of South Australia; Director of Pharmacy, Repatriation General Hospital

Reprints: Christopher P Alderman BPharm FSHP BCPP CGP, Pharmacy Department, Repatriation General Hospital, Daw Park, South Australia 5041, FAX 08 83740225, Chris.Alderman{at}rgh.sa.gov.au

BACKGROUND: Venous thromboembolism (VTE) is relatively common among hospitalized patients, is often clinically silent, and is associated with substantial morbidity and mortality. Risk stratification and routine use of thromboprophylaxis for patients at moderate to high risk for VTE are key strategies that can be used to prevent VTE.

OBJECTIVE: To assess the appropriateness of the selection and implementation of thromboprophylactic measures for prevention of VTE within a South Australian teaching hospital.

METHODS: Guidelines for risk stratification and prophylaxis were compiled from a range of studies, consensus statements, and tertiary references. Using prospective, observational methodology, data collection was performed through case note audit for 130 inpatient admissions over a 4-week period.

RESULTS: The decisions regarding the usage of thromboprophylaxis were considered inappropriate in 32% of cases in the study cohort. Suboptimal practices were also observed with respect to factors including the choice between mechanical and pharmacologic methods and the timing of initiation and cessation of thromboprophylaxis.

CONCLUSIONS: These findings provide evidence suggesting that the selection and implementation of thromboprophylaxis require improvement and that appropriate means to facilitate this improvement need to be developed and evaluated through future research.

Key Words: Australia, prophylaxis, thromboembolism

Published Online, July 25, 2003. www.theannals.com, DOI 10.1345/aph.1D100

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