Reducing Hospitalizations and Emergency Department Visits in Patients With Venous Thromboembolism Using a...

Area of Science:

• Internal Medicine
• Pharmacology
• Public Health

Background:

• Preventing hospital and emergency department (ED) utilization after venous thromboembolism (VTE) diagnosis is a significant clinical challenge.
• Effective interventions are needed to manage patients post-VTE and reduce healthcare resource burden.

Purpose of the Study:

• To evaluate the impact of a multicomponent care transition intervention on hospitalizations and ED visits following a VTE diagnosis.
• To assess the relationship of these visits to VTE recurrence, bleeding, or anticoagulation management.

Main Methods:

• A randomized controlled trial comparing a multicomponent intervention (home pharmacist visit, illustrated medication instructions, expert phone follow-up) to usual care.
• Adults with new-onset VTE were randomized.
• Hospital and ED visits were tracked for 90 days post-randomization via physician chart review.

Main Results:

• The incidence rate of visits was 4.50 per 1000 patient-days in the intervention group versus 6.01 in the control group (IRR=0.71, 95% CI 0.40-1.27).
• The adjusted incidence rate ratio for the intervention was 1.05 (95% CI 0.57-1.91).
• Most visits were unrelated to VTE or bleeding, and among those related, the majority were not preventable.

Conclusions:

• The tested multicomponent care transition intervention did not significantly decrease hospitalizations or ED visits for patients with VTE.
• A substantial proportion of post-VTE healthcare utilization is not directly related to the condition or its complications and may not be preventable by this intervention.