PMID- 11449344
OWN - NLM
STAT- MEDLINE
DCOM- 20011214
LR  - 20191105
IS  - 0037-1963 (Print)
IS  - 0037-1963 (Linking)
VI  - 38
IP  - 2 Suppl 5
DP  - 2001 Apr
TI  - Clinical and economic aspects of managing venous thromboembolism in the 
      outpatient setting.
PG  - 58-66
AB  - Low-molecular-weight heparins (LMWHs) are at least as effective and safe as 
      unfractionated heparin (UFH) in the prevention and initial treatment of venous 
      thromboembolism (VTE), and their fixed-dose, once- or twice-daily dosing regimen 
      without laboratory monitoring makes them suitable for outpatient use. 
      Postoperative thromboprophylaxis usually continues until hospital discharge, but 
      evidence demonstrates that the VTE risk persists for several weeks. Economic 
      pressures, changes in clinical practice, and patient preferences make hospital 
      stays shorter. As a result, outpatient thromboprophylaxis with LMWH has been 
      investigated. LMWH self-administered at home once daily for up to 4 weeks after 
      hospital discharge is safe and well tolerated and significantly reduces the 
      incidence of postdischarge VTE after hip replacement. Targeted appropriately, 
      extended thromboprophylaxis may be cost effective, and the development of an 
      autoinjection device may increase the proportion of patients eligible for home 
      management. LMWHs may also be of value as long-term secondary thromboprophylaxis 
      in patients with contraindications to oral anticoagulants. Standard initial 
      treatment for VTE comprises intravenous UFH administered to the patient in the 
      hospital. However, three large-scale studies have demonstrated the efficacy and 
      safety of outpatient treatment of acute VTE using LMWHs. The economic benefits of 
      shortening or eliminating inpatient therapy are substantial, but successful home 
      treatment requires careful patient selection, intensive education and a 
      comprehensive system of professional support to optimize compliance and safety.
CI  - Copyright 2001 by W.B. Saunders Company.
FAU - Agnelli, G
AU  - Agnelli G
AD  - Division of Internal and Cardiovascular Medicine, Department of Internal 
      Medicine, University of Perugia, Perugia, Italy.
FAU - Becattini, C
AU  - Becattini C
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Semin Hematol
JT  - Seminars in hematology
JID - 0404514
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Ambulatory Care/economics
MH  - Disease Management
MH  - Heparin, Low-Molecular-Weight/administration & dosage/economics
MH  - Humans
MH  - Thromboembolism/drug therapy/economics/prevention & control
MH  - Venous Thrombosis/*drug therapy/economics/prevention & control
RF  - 66
EDAT- 2001/07/13 10:00
MHDA- 2002/01/05 10:01
CRDT- 2001/07/13 10:00
PHST- 2001/07/13 10:00 [pubmed]
PHST- 2002/01/05 10:01 [medline]
PHST- 2001/07/13 10:00 [entrez]
AID - ashem0380058 [pii]
AID - 10.1016/s0037-1963(01)90099-x [doi]
PST - ppublish
SO  - Semin Hematol. 2001 Apr;38(2 Suppl 5):58-66. doi: 10.1016/s0037-1963(01)90099-x.