PMID- 21690430
OWN - NLM
STAT- MEDLINE
DCOM- 20120514
LR  - 20220321
IS  - 1535-2900 (Electronic)
IS  - 1079-2082 (Linking)
VI  - 68
IP  - 13
DP  - 2011 Jul 1
TI  - Anticoagulation therapy for hospitalized patients: patterns of use, compliance 
      with national guidelines, and performance on quality measures.
PG  - 1239-44
LID - 10.2146/ajhp100543 [doi]
AB  - PURPOSE: The use of anticoagulant therapy for the prevention and treatment of 
      venous thromboembolism (VTE) and acute coronary syndrome (ACS) among hospital 
      inpatients was evaluated. METHODS: Medication-use data were retrospectively 
      collected on 1716 patients who received anticoagulants for VTE or ACS at 42 
      community hospitals during the period April-June 2009; all hospitals in the 
      sample were members of the same large health care organization. Descriptive 
      analyses were performed to characterize anticoagulant use, patient safety, 
      compliance with national prescribing guidelines, and performance on relevant 
      Joint Commission quality measures. RESULTS: The most common indications for 
      anticoagulant use were VTE prophylaxis (67.5% of cases), ACS (13.5% of cases), 
      and VTE treatment (11.9% of cases). The agents most commonly used for VTE 
      prophylaxis were subcutaneous enoxaparin (70% of cases) and subcutaneous 
      unfractionated heparin (UFH). Overall, the anticoagulant regimen used was 
      consistent with national prescribing guidelines in 67.5% of cases; however, rates 
      of appropriate prescribing were lower in subgroups of patients with renal 
      impairment, obesity, or both (63.6%, 42.5%, and 63.6%, respectively). Reported 
      anticoagulant-related adverse events during the study period mainly involved 
      minor or major bleeding, which occurred in 36% and 32% of cases, respectively. 
      Compliance with Joint Commission core measures ranged from 49.1% for core measure 
      VTE-3 (warfarin overlap therapy) to 72.3% for VTE-4 (monitoring of UFH dosages 
      and platelet counts by protocol). CONCLUSION: Among hospitals in a large national 
      health care system, the most common use of anticoagulants in hospitalized 
      patients was for VTE prevention, followed by ACS and VTE treatment. Enoxaparin 
      and UFH were the most commonly used agents for each indication, and the selection 
      and use of anticoagulants were in compliance with national guidelines in the 
      majority of patients for whom those drugs were prescribed.
FAU - Tiryaki, Funda
AU  - Tiryaki F
AD  - Center for Pharmacoeconomic Research, University of Illinois at Chicago, 60612, 
      USA.
FAU - Nutescu, Edith A
AU  - Nutescu EA
FAU - Hennenfent, Joel A
AU  - Hennenfent JA
FAU - Karageanes, Annette M
AU  - Karageanes AM
FAU - Koesterer, Larry J
AU  - Koesterer LJ
FAU - Lambert, Bruce L
AU  - Lambert BL
FAU - Schumock, Glen T
AU  - Schumock GT
LA  - eng
GR  - KL2RR029878/RR/NCRR NIH HHS/United States
GR  - U18HS016973/HS/AHRQ HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - England
TA  - Am J Health Syst Pharm
JT  - American journal of health-system pharmacy : AJHP : official journal of the 
      American Society of Health-System Pharmacists
JID - 9503023
RN  - 0 (Anticoagulants)
SB  - IM
MH  - Acute Coronary Syndrome/drug therapy/prevention & control
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/standards/*therapeutic use
MH  - Female
MH  - *Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Patient Compliance
MH  - *Practice Guidelines as Topic/standards
MH  - Quality Assurance, Health Care/*methods/standards
MH  - Retrospective Studies
MH  - Thrombolytic Therapy/*methods/standards
MH  - Venous Thromboembolism/drug therapy/prevention & control
EDAT- 2011/06/22 06:00
MHDA- 2012/05/15 06:00
CRDT- 2011/06/22 06:00
PHST- 2011/06/22 06:00 [entrez]
PHST- 2011/06/22 06:00 [pubmed]
PHST- 2012/05/15 06:00 [medline]
AID - 68/13/1239 [pii]
AID - 10.2146/ajhp100543 [doi]
PST - ppublish
SO  - Am J Health Syst Pharm. 2011 Jul 1;68(13):1239-44. doi: 10.2146/ajhp100543.