Related Experiment Video

Updated: Sep 8, 2025

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
11:17

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

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Impact of Pharmacist-To-Dose Enoxaparin in Pediatric Patients

Yi Fei Heng1, Andrew Allison1, Emily Clemons1

  • 1Department of Pharmacy (YFH, AA, EC), WVU Medicine Children's Hospital, Morgantown, WV.

The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG
|August 20, 2025
PubMed

Insights

Pharmacist-to-dose (PTD) protocols did not significantly change target anti-Xa levels in pediatric enoxaparin patients. However, PTD improved the accuracy and speed of achieving therapeutic anticoagulation, demonstrating pharmacists' equal quality of care.

Area of Science:

  • Pediatric pharmacology
  • Pharmacokinetics
  • Anticoagulation therapy

Background:

  • Enoxaparin pharmacokinetics vary in pediatric patients, necessitating anti-Xa level monitoring for effective anticoagulation.
  • Pharmacist-to-dose (PTD) protocols are crucial for optimizing enoxaparin therapy in children for venous thromboembolism prophylaxis and treatment.

Purpose of the Study:

  • To evaluate the impact of implementing a pharmacist-led enoxaparin dosing protocol (PTD) on achieving target anti-Xa concentrations in pediatric patients.
  • To compare the rates of therapeutic anti-Xa concentrations before and after PTD protocol implementation.

Main Methods:

  • Retrospective review of inpatient pediatric enoxaparin use (January 2016-September 2023) at a children's hospital.
  • Assessment of enoxaparin indication, dosing, administration, and anti-Xa concentration timing and goal achievement.
  • Analysis of secondary outcomes including number of anti-Xa levels drawn, dose adjustments, accuracy, and time to goal.

Main Results:

  • No significant difference was observed in the rate of achieving goal anti-Xa concentrations before and after PTD protocol implementation.
  • A higher frequency of appropriately drawn anti-Xa concentrations and a shorter time to goal were noted post-PTD, though not statistically significant.

Conclusions:

  • Implementation of a PTD protocol did not alter the primary outcome of achieving target anti-Xa concentrations.
  • The consistent use of dose adjustment guidelines contributed to similar therapeutic outcomes.
  • Pharmacist involvement, even without altering goal achievement rates, positively impacts the efficiency of monitoring and achieving therapeutic anticoagulation.
Abstract

Keywords:
anticoagulationenoxaparinpediatricspharmacistprotocolvenous thromboembolism

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