Outpatient treatment of venous thromboembolic disease based in an emergency department.
OBJECTIVE
The efficacy, safety, and patient satisfaction of an emergency department (ED)-based outpatient program providing treatment for venous thromboembolic disease (VTD) were studied.


METHODS
A prospective cohort study of patients enrolled in a hospital outpatient VTD treatment program was conducted from June 1999 to September 2003. Endpoints included recurrent VTD at three and six months following discharge from the program, minor and major bleeding, and thrombocytopenia during the acute phase of therapy. Patient satisfaction was assessed with an 18-question survey that was mailed to all patients following discharge from the program.


RESULTS
A total of 162 patients were included. Of the 142 evaluable patients, no patient experienced recurrent VTD at three months, while at six months, 2 patients (1.4%; 95% confidence interval [CI], 0.2-5.0%) had recurrence. No patient experienced major bleeding or thrombocytopenia, while 4 (2.5%; 95% CI, 0.8-6.2%) had minor bleeding. Ninety-seven percent of the patients were comfortable having their condition treated on an outpatient basis, and 85.1% felt it was more convenient to return to the hospital daily for medications and assessment than to be admitted to the hospital. Overall, 97.7% of the respondents were satisfied or very satisfied with the treatment received in the outpatient program, and 94.0% said they would enroll again if future treatment was indicated.


CONCLUSIONS
An ED-based outpatient VTD treatment program was safe and effective and appeared to achieve a high level of patient satisfaction.
Zed
Peter J
PJ
Division of Emergency Medicine, Department of Surgery, University of British Columbia (UBC), Vancouver, BC, Canada V5Z 1M9. zed@interchange.ubc.ca
Filiatrault
Lyne
L
Busser
James R
JR
D000553:Ambulatory Care / Q000379:methods*; D001955:British Columbia; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D023381:Endpoint Determination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D000078222:Tinzaparin; D020246:Venous Thrombosis / Q000209:etiology / Q000628:therapy*
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D000078222:Tinzaparin