Portal de Periódicos da CAPES

Patient Education Program for Venous Thromboembolism Prevention in Hospitalized Patients

2012; Elsevier BV; Volume: 125; Issue: 3 Linguagem: Inglês

10.1016/j.amjmed.2011.09.012

1555-7162

Gregory Piazza, Nha Thanh Nguyen, Ruth Morrison, Deborah Cios, Benjamin Hohlfelder, John Fanikos, Marilyn D. Paterno, Samuel Z. Goldhaber,

Peripheral Artery Disease Management

Abstract Purpose Up to 15% of clinician-ordered doses of injectable pharmacological prophylaxis to prevent venous thromboembolism are not administered. Patient refusal accounts for nearly 50% of these omitted doses. We conducted a prospective cohort study to determine whether a patient education program would improve medication adherence to clinician-ordered injectable prophylactic anticoagulation. Methods We identified 528 hospitalized patients ordered to receive injectable pharmacological venous thromboembolism prophylaxis. We evaluated the impact of pharmacist-led patient education sessions on medication adherence (defined as the ratio of doses administered to doses scheduled) compared with our historical cohort. Results Individualized patient education sessions were conducted within 24 hours of the initial order for prophylactic anticoagulation in 99% of patients. Adherence to clinician-ordered pharmacological venous thromboembolism prophylaxis was higher after the patient education program than in our historical cohort (94.4% vs 89.9%, P <.0001). The proportion of patients receiving 100% of scheduled doses of injectable pharmacological venous thromboembolism prophylaxis was higher after our novel patient education program than in our historical cohort (73.7% vs 62.4%, P =.001). Patient refusal as a reason for omitted doses was less frequent after the patient education program (29.3% vs 43.7%, P =.001). Conclusion Pharmacist-led individualized patient education sessions were associated with higher medication adherence to clinician-ordered injectable pharmacological venous thromboembolism prophylaxis and a reduction in patient refusal as a reason for omitted doses. A randomized controlled trial to evaluate the impact of a patient education program on medication adherence to pharmacological venous thromboembolism prophylaxis is warranted.