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Clinical and economic outcomes with appropriate or partial prophylaxis
1University of California, Irvine, Orange, CA92868, USA. anamin@uci.edu
Thrombosis Research
|November 26, 2009
Summary
Appropriate venous thromboembolism (VTE) prophylaxis, as recommended by guidelines, significantly reduces pulmonary embolism and bleeding events. This adherence to VTE prevention strategies also proves cost-effective for healthcare systems.
Area of Science:
- Medical research
- Clinical pharmacology
- Health economics
Background:
- Evidence-based guidelines exist for venous thromboembolism (VTE) prevention.
- Prophylaxis for VTE is frequently prescribed inappropriately.
- This study evaluates appropriate versus partial VTE prophylaxis.
Purpose of the Study:
- Compare the efficacy, safety, and cost of appropriate (ACCP-recommended) VTE prophylaxis versus partial prophylaxis.
- Assess outcomes in high-risk VTE patients receiving enoxaparin or unfractionated heparin.
Main Methods:
- Retrospective analysis of the MarketScan Hospital Drug Database (2004-2007).
- Included were medical and surgical patients aged >=40 years with VTE risk and >=6-day hospital stay.
- Compared hospital-acquired VTE, adverse events, and costs between appropriate and partial prophylaxis groups.
Main Results:
- Appropriate prophylaxis was given to 24.5% of 21,001 patients.
- Appropriate prophylaxis showed lower incidences of hospital-acquired pulmonary embolism (0.5% vs 0.9%) and bleeding events (5.1% vs 10.7%).
- Appropriate prophylaxis resulted in significantly lower total costs per discharge ($17,386 vs $23,823).
Conclusions:
- ACCP-guideline recommended VTE prophylaxis reduces hospital-acquired pulmonary embolism and bleeding.
- Appropriate VTE prophylaxis is cost-saving when considering total direct medical costs.
- Improving adherence to VTE prophylaxis guidelines can decrease the clinical and economic burden of VTE.
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