PMID- 34459268
OWN - NLM
STAT- MEDLINE
DCOM- 20220505
LR  - 20220505
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 56
IP  - 5
DP  - 2022 May
TI  - Effectiveness and Safety of Twice- Versus Thrice-Daily Subcutaneous Heparin for 
      Venous Thromboembolism Prophylaxis at a Large Academic Medical Center.
PG  - 541-547
LID - 10.1177/10600280211041380 [doi]
AB  - BACKGROUND: Dosing variation of subcutaneous unfractionated heparin (UFH) exist 
      for venous thromboembolism prophylaxis (VTEP). OBJECTIVE: The purpose of this 
      study was to compare the safety and effectiveness of thrice-daily (TID) versus 
      twice-daily (BID) administration of UFH during a heparin shortage for VTEP. 
      METHODS: A single-center retrospective analysis was conducted in patients with 
      orders for BID subcutaneous UFH during a heparin shortage from September 1, 2019, 
      to February 4, 2020. These patients were matched to patients with TID 
      subcutaneous UFH orders from January 1, 2019, to May 31, 2019. The primary 
      outcome was the incidence of deep-vein thrombosis or pulmonary embolism confirmed 
      by imaging during hospitalization. The secondary outcome was the incidence of 
      major or clinically relevant nonmajor bleeding events as defined by International 
      Society on Thrombosis and Haemostasis (ISTH) definitions. RESULTS: A total of 277 
      patients with orders for BID UFH and meeting inclusion criteria were evaluated 
      and matched to patients who received TID UFH. After the exclusion criteria were 
      implemented, 510 patients remained in the TID group. The primary outcome occurred 
      in 4% of patients in the BID group and 3% in the TID group (P = 0.645). Major 
      bleeding or clinically relevant nonmajor bleeding events occurred in 10% of 
      patients in the BID group and 8% in the TID group (P = 0.310). CONCLUSION AND 
      RELEVANCE: There was no difference in effectiveness or safety of TID versus BID 
      subcutaneous UFH for VTEP. During a heparin shortage, transitioning patients to 
      BID UFH for VTEP to conserve supply may be considered.
FAU - Wiethorn, Eryne E
AU  - Wiethorn EE
AUID- ORCID: 0000-0003-4988-7485
AD  - Indiana University Health, Indianapolis, IN, USA.
FAU - Harrison, Sarah
AU  - Harrison S
AD  - Medical University of South Carolina, Charleston, SC, USA.
FAU - Weeda, Erin R
AU  - Weeda ER
AUID- ORCID: 0000-0001-7876-5802
AD  - Medical University of South Carolina, Charleston, SC, USA.
FAU - Bell, Carolyn Magee
AU  - Bell CM
AUID- ORCID: 0000-0001-7024-9934
AD  - Medical University of South Carolina, Charleston, SC, USA.
LA  - eng
PT  - Journal Article
DEP - 20210829
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Academic Medical Centers
MH  - Anticoagulants/therapeutic use
MH  - Hemorrhage/chemically induced/drug therapy
MH  - *Heparin/adverse effects
MH  - Heparin, Low-Molecular-Weight
MH  - Humans
MH  - Retrospective Studies
MH  - *Venous Thromboembolism/chemically induced/drug therapy/prevention & control
OTO - NOTNLM
OT  - unfractionated heparin
OT  - venous thromboembolism prophylaxis
EDAT- 2021/08/31 06:00
MHDA- 2022/05/06 06:00
CRDT- 2021/08/30 08:41
PHST- 2021/08/31 06:00 [pubmed]
PHST- 2022/05/06 06:00 [medline]
PHST- 2021/08/30 08:41 [entrez]
AID - 10.1177/10600280211041380 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2022 May;56(5):541-547. doi: 10.1177/10600280211041380. Epub 
      2021 Aug 29.