Blood Clots: Patients At Risk Not Getting Recommended Treatment

The most common cause of preventable death in hospital settings is venous thromboembolism (VTE), which includes deep-vein thrombosis (DVT), or blood clots in leg veins, and pulmonary embolism (PE), or clots that travel to the lungs,

These dangerous clots can be prevented by an approach called VTE prophylaxis. It reduces mortality by as much as 80%, but VTE prophylaxis is not always prescribed for high-risk patients.

In a recent study researchers found that even after educating healthcare providers about the need for VTE prophylaxis, substantial numbers of patients did not receive the recommended treatment.

Explained lead investigator Colette Seifer, MB (Hons), FRCP (UK), Associate Professor, Department of Internal Medicine, University of Manitoba, St. Boniface Hospital:

“Awareness and education surrounding VTE prophylaxis is challenging in the inpatient teaching unit model due to a number of factors, including the high turnover of senior and junior physicians as well as nursing staff. A single time point intervention is unlikely to result in a sustained improvement in VTE prophylaxis rates.”

With the introduction of electronic patient records and innovative software programs, the investigators suggest, automated alerts and checklists have the potential to improve compliance rates. Nevertheless, they concluded:

“There is a high rate of noncompliance with accepted guidelines for the prevention of VTE. The introduction of a guideline-based protocol significantly increased compliance. However, a substantial proportion of patients at high risk for VTE, still did not receive prophylaxis.”

Mehrdad Golian, Motaz Moussa, Charlene White, Giuseppe Aletta, Lillian Koley, Colette Seifer
Venous Thromboembolism Prophylaxis on a Cardiology In-Patient Unit: A Surprising Result?
Canadian Journal of Cardiology, doi:10.1016/j.cjca.2015.05.023

Photo: Janice Haney Carr/CDC

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