Patient Education Program for Venous Thromboembolism Prevention in Hospitalized Patients - 16/02/12
, Thanh Nha Nguyen, PharmD b, Ruth Morrison, RN b, Deborah Cios, PharmD c, Benjamin Hohlfelder b, John Fanikos, RPh, MBA c, Marilyn D. Paterno, MBI d, Samuel Z. Goldhaber, MD a
Requests for reprints should be addressed to Gregory Piazza, MD, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St., Boston, MA 02115Abstract |
Purpose |
Up to 15% of clinician-ordered doses of injectable pharmacological prophylaxis to prevent venous thromboembolism are not administered. Patient refusal accounts for nearly 50% of these omitted doses. We conducted a prospective cohort study to determine whether a patient education program would improve medication adherence to clinician-ordered injectable prophylactic anticoagulation.
Methods |
We identified 528 hospitalized patients ordered to receive injectable pharmacological venous thromboembolism prophylaxis. We evaluated the impact of pharmacist-led patient education sessions on medication adherence (defined as the ratio of doses administered to doses scheduled) compared with our historical cohort.
Results |
Individualized patient education sessions were conducted within 24 hours of the initial order for prophylactic anticoagulation in 99% of patients. Adherence to clinician-ordered pharmacological venous thromboembolism prophylaxis was higher after the patient education program than in our historical cohort (94.4% vs 89.9%, P <.0001). The proportion of patients receiving 100% of scheduled doses of injectable pharmacological venous thromboembolism prophylaxis was higher after our novel patient education program than in our historical cohort (73.7% vs 62.4%, P=.001). Patient refusal as a reason for omitted doses was less frequent after the patient education program (29.3% vs 43.7%, P=.001).
Conclusion |
Pharmacist-led individualized patient education sessions were associated with higher medication adherence to clinician-ordered injectable pharmacological venous thromboembolism prophylaxis and a reduction in patient refusal as a reason for omitted doses. A randomized controlled trial to evaluate the impact of a patient education program on medication adherence to pharmacological venous thromboembolism prophylaxis is warranted.
Le texte complet de cet article est disponible en PDF.Keywords : Anticoagulation, Medication adherence, Patient education, Prevention, Venous thromboembolism
Plan
| Funding: This study was funded, in part, by an unrestricted clinical research grant from sanofi-aventis. Dr Goldhaber (Principal Investigator), Thanh Nha Nguyen (research pharmacist), and Ruth Morrison (research nurse) were partially compensated with these funds. Dr Piazza is supported by a Research Career Development Award (K12 HL083786) from the National Heart, Lung, and Blood Institute (NHLBI). |
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| Conflict of Interest: Dr Goldhaber receives clinical research grant support from sanofi-aventis. None of the other authors have any conflicts of interest to disclose. |
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| Authorship: All of the authors had access to the data and participated in the writing of the manuscript. |
Vol 125 - N° 3
P. 258-264 - mars 2012 Retour au numéro
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