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CARDIOLOGY

Hospital Guidelines for Use of Low-Molecular-Weight Heparins

Director, Antithrombosis Services; Clinical Assistant Professor, Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL

Richard K Lewis, PharmD MBA

Vice President, Pharmacy Services, Mercy Resource Management Inc., Naperville, IL; Clinical Assistant Professor, Department of Pharmacy Practice, University of Illinois at Chicago

Jamie M Finley, PharmD

Coordinator of Clinical Pharmacy Programs, Mercy Resource Management Inc.; Clinical Assistant Professor, Department of Pharmacy Practice, University of Illinois at Chicago

Glen T Schumock, PharmD MBA

Director, Center for Pharmacoeconomic Research; Associate Professor, Department of Pharmacy Practice, University of Illinois at Chicago

Reprints: Glen T Schumock PharmD MBA, Department of Pharmacy Practice, 833 S. Wood St. (M/C 886), Chicago, IL 60612-7230, FAX 312/996-0379, E-mail schumock{at}uic.edu

OBJECTIVE: To describe the development of guidelines for initial use of low-molecular-weight heparins (LMWHs) and other anticoagulants in acute-care hospitals that are part of a national group purchasing organization (GPO).

DATA SOURCES: A systematic literature search (1970–December 2001) was conducted to identify evidence on the efficacy of various anticoagulants for initial therapy in deep-vein thrombosis and pulmonary embolism, and in treatment of acute coronary syndrome. A group consensus method was then used to develop guidelines. Guidelines were reviewed and revised by an internal expert panel as well as an external expert panel. Final guidelines were disseminated to GPO members and assistance was provided with implementation at the local level.

RESULTS: The final set of guidelines is described. The guidelines are organized based on recommended therapeutic options for each indication. For each option, consensus opinion is provided on the level of evidence that exists in the literature, comparisons of cost and convenience, and additional dosing information. The guidelines were disseminated along with supporting material to interested GPO member hospitals, and teleconferences were held to facilitate implementation at the local level. The guidelines were initially implemented at 18 hospitals across the country.

CONCLUSIONS: The process by which these guidelines were developed, plus the final set of guidelines, may be useful to hospitals and healthcare systems contemplating or engaged in a similar effort with this class of drugs.

Key Words: anticoagulation, low-molecular-weight heparins, prescribing guidelines

Published Online, June 10, 2003. www.theannals.com, DOI 10.1345/aph.1C400

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-03-019-H01

This article has been cited by other articles:

				V. Vats, E. A. Nutescu, J. C. Theobald, J. E. Wojtynek, and G. T. Schumock Survey of hospitals for guidelines, policies, and protocols for anticoagulants Am. J. Health Syst. Pharm., June 1, 2007; 64(11): 1203 - 1208. [Abstract] [Full Text] [PDF]

				G. T Schumock, J. C Blackburn, E. A Nutescu, S. M Walton, J. M Finley, and R. K Lewis Impact of Prescribing Guidelines for Inpatient Anticoagulation Ann. Pharmacother., October 1, 2004; 38(10): 1570 - 1575. [Abstract] [Full Text] [PDF]