PMID- 16300419
OWN - NLM
STAT- MEDLINE
DCOM- 20060216
LR  - 20230823
IS  - 1083-4087 (Print)
IS  - 1944-706X (Electronic)
IS  - 1083-4087 (Linking)
VI  - 11
IP  - 9
DP  - 2005 Nov-Dec
TI  - Effect of a clinical pharmacy education program on improvement in the quantity 
      and quality of venous thromboembolism prophylaxis for medically ill patients.
PG  - 755-62
LID - 10.18553/jmcp.2005.11.9.755
AB  - OBJECTIVE: The American College of Chest Physicians (ACCP) recommends 
      unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) for 
      prevention of venous thromboembolism (VTE) in medically ill patients. Despite 
      these recommendations, a previous analysis at our institution revealed a low 
      utilization of VTE prophylaxis in medically ill patients. Our objective was to 
      evaluate the effects of a pharmacy-driven education program on the quantity and 
      quality of VTE prophylaxis in medically ill patients. METHODS: An educational 
      program focusing on the importance of VTE prophylaxis in medically ill patients 
      was developed by clinical pharmacists and presented to nurses, pharmacists, and 
      physicians in a 493-bed community teaching hospital. The educational program was 
      conducted between June 2002 and June 2003 and consisted of in-service 
      presentations, newsletters, and quality assurance presentations on VTE 
      prophylaxis. The educational program focused on 4 main points: (1) hospitalized 
      medically ill patients are at risk for developing VTE, (2) how to identify 
      medically ill patients who require VTE prophylaxis, (3) the fact that VTE 
      prophylaxis is currently underutilized in medically ill patients, and (4) 
      appropriate VTE prophylaxis strategies for medically ill patients. A 
      posteducation retrospective chart review was performed in medically ill patients 
      with discharge dates between October 2003 and March 2004, and these posteducation 
      medical chart data were compared with the results from a preeducation analysis of 
      patents with discharge dates from January 2001 to March 2002. Data collection 
      included patient demographics, VTE risk factors, and use and type of VTE 
      prophylaxis. RESULTS: The posteducation retrospective chart review was performed 
      for 297 medically ill patients with discharge dates between October 2003 and 
      March 2004 and for 344 preeducation patients discharged between January 2001 and 
      March 2002. Patient demographics and primary diagnoses were similar between the 
      preeducation and posteducatin groups. The mean number of risk factors per patient 
      in the preeducation group was 2.53 +/- 0.96 versus 2.38 +/- 0.88 in the 
      posteducation group (P=0.626). Pharmacy education was associated with an increase 
      in the utilization of any VTE prophylaxis (43% in the preperiod vs. 58% in the 
      postperiod; P <0.001). Prophylaxis judged to be suitable (UFH 5,000 units twice 
      daily, or UFH 5,000 units 3 times daily, or LMWH once daily), increased from 38% 
      in the preeducation period to 49% in the posteducation period, P=0.006). 
      Prophylaxis judged to be optimal (UFH 3 times daily or LMWH once daily) increased 
      from 11% to 44% of patients, P <0.001). CONCLUSIONS: A hospital-wide clinical 
      pharmacy education program was associated with significant improvement in the 
      quantity and quality of VTE prophylaxis in medically ill patients in a community 
      teaching hospital.
FAU - Dobesh, Paul P
AU  - Dobesh PP
AD  - College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198-6045, 
      USA. pdobesh@unmc.edu
FAU - Stacy, Zachary A
AU  - Stacy ZA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Manag Care Pharm
JT  - Journal of managed care pharmacy : JMCP
JID - 9605854
RN  - 0 (Heparin, Low-Molecular-Weight)
SB  - IM
MH  - Aged
MH  - Female
MH  - Guideline Adherence
MH  - Health Personnel/*education
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - *Inservice Training
MH  - Male
MH  - Quality Assurance, Health Care
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Thromboembolism/*prevention & control
MH  - Venous Thrombosis/*prevention & control
PMC - PMC10437579
EDAT- 2005/11/23 09:00
MHDA- 2006/02/17 09:00
PMCR- 2005/11/01
CRDT- 2005/11/23 09:00
PHST- 2005/11/23 09:00 [pubmed]
PHST- 2006/02/17 09:00 [medline]
PHST- 2005/11/23 09:00 [entrez]
PHST- 2005/11/01 00:00 [pmc-release]
AID - 2005(11)9: 755-762 [pii]
AID - 10.18553/jmcp.2005.11.9.755 [doi]
PST - ppublish
SO  - J Manag Care Pharm. 2005 Nov-Dec;11(9):755-62. doi: 10.18553/jmcp.2005.11.9.755.