title: Audit of anticoagulant therapy of pulmonary embolus, deep vein thrombosis and thrombophlebitis.
abstract: The use of heparin sodium and warfarin sodium in the treatment of pulmonary embolus (PE), deep vein thrombosis (DVT) and thrombophlebitis (TP) was studied by a hospital pharmacy department. During a four-month period, the charts of 26 patients were audited for anticoagulant dosages used; laboratory test monitoring of anticoagulant dosage used; laboratory test minitoring of anticoagulant therapy; complications of, contraindications to, and patient compliance with anticoagulant therapy. These variables were evaluated on the basis of compliance with a written anticoagulant protocol. Initial doses of heparin sodium and warfarin sodium were acceptable in 43% of patients. Maintenance dosing with heparin sodium was acceptable in 89% of patients. Activated partial thromboplastin times (APTT) were ordered correctly for 65% of patients. APTTs were within therapeutic ranges in 31% of patients. The duration of heparin-warfarin overlap was possibly to definitely acceptable in 71% of patients. Prothrombin times were properly monitored in 50% of patients. Complications of anticoagulant therapy were evident in only one patient. There were a number of potentially serious diversions from the protocol. The pharmacy department planned to issue bulletins designed to correct the problems.
mesh_terms: D000328:Adult; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy*; D013924:Thrombophlebitis / Q000188:drug therapy*; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D014859:Warfarin; D006493:Heparin