Abstract 9832: Individualized Patient Education Program for Prevention of Venous Thromboembolism in Hospitalized Medical Patients
Introduction: Up to 15% of clinician-ordered doses of injectable prophylactic unfractionated or low-molecular weight heparin to prevent venous thromboembolism (VTE) are not administered. Patient refusal accounts for nearly 50% of these omitted doses.
Hypothesis: We hypothesized that a pharmacist-led individualized patient education program will improve medication adherence to clinician-ordered doses of injectable prophylactic anticoagulation.
Methods: Using our hospital's Electronic Health Record, we identified 528 hospitalized medical patients who were ordered for injectable pharmacological VTE prophylaxis. We evaluated the impact of pharmacist-led individualized patient education sessions, conducted within 24 hours of the initial order for prophylactic anticoagulation, on medication adherence (defined as the ratio of doses administered to doses scheduled).
Results: Unfractionated heparin was the most frequent clinician-ordered injectable prophylactic anticoagulant (55%) followed by dalteparin (45%). Individualized patient education sessions were conducted within 24 hours of the first dose of prophylactic anticoagulation in 99% of patients. The patient education program improved adherence to clinician-ordered pharmacological VTE prophylaxis from 89.9% in our historical cohort to 94.4% (p<0.0001). The proportion of patients receiving 100% of scheduled doses of pharmacological prophylaxis increased from 82.8% to 91.9% (p=0.001). Patient refusal as a reason for omitted doses decreased from 43.7% to 29.3% after the patient education program (p=0.001).
Conclusion: Pharmacist-led individualized patient education sessions improved medication adherence to clinician-ordered pharmacological VTE prophylaxis and reduced patient refusal as a cause of omitted doses. Efforts to enhance VTE prevention among hospitalized medical patients should focus on patient education to improve adherence to pharmacological VTE prophylaxis.
- © 2011 by American Heart Association, Inc.