Survey of hospitals for guidelines, policies, and protocols for anticoagulants.
OBJECTIVE
A survey of community hospitals that are part of a national group purchasing organization (GPO) was conducted to assess the formulary status of currently available anticoagulants, assess the current status of anticoagulant prescribing guidelines and the existing scope of such guidelines, and identify perceptions about the appropriateness of the use of anticoagulants in community hospitals in the United States.


METHODS
A Web-based survey of acute care hospitals that were members of a leading health care resource management and GPO was conducted. The survey was sent to 224 hospitals.


RESULTS
Of 224 hospitals, 127 participated in the survey, a response rate of 59.6%. Warfarin, unfractionated heparin (UFH), and enoxaparin were the anticoagulants most commonly included (>80%) on the hospitals' drug formularies. Guidelines relating to the use of UFH and low-molecular-weight heparins (LMWHs) existed in approximately 87.4% and 55.1% of responding hospitals, respectively, followed by warfarin and direct thrombin inhibitors (DTIs) (approximately 44.1% and 30.7%, respectively). Among hospitals without guidelines, 78.2%, 72.1%, 65.4%, 50.0%, and 41.4% reported that such guidelines would be useful if they included LMWHs, warfarin, DTIs, UFH, and fondaparinux, respectively. Guidelines for prophylaxis of venous thromboembolism (VTE), appropriate drug selection, and dosing for VTE prophylaxis and treatment existed in 59.8%, 53.5%, and 43.3% of the hospitals, respectively.


CONCLUSIONS
The study found that a sizable percentage of the responding community hospitals did not have guidelines, protocols, or policies related to the use of anticoagulants. Further, those hospitals without such guidelines commonly reported a need for clinical practice guidelines.
Vats
Vikrant
V
Center for Pharmacoeconomic Research, College of Pharmacy, University of Illinois at Chicago, Chicago, IL 60612, USA.
Nutescu
Edith A
EA
Theobald
John C
JC
Wojtynek
Jeffrey E
JE
Schumock
Glen T
GT
D000925:Anticoagulants / Q000627:therapeutic use*; D003327:Coronary Disease / Q000188:drug therapy; D003625:Data Collection; D017723:Drug Utilization Review; D005572:Formularies, Hospital as Topic; D017754:Group Purchasing; D019538:Health Care Surveys; D006764:Hospitals, Community / Q000706:statistics & numerical data; D006801:Humans; D016134:Organizational Policy; D010607:Pharmacy Service, Hospital / Q000458:organization & administration* / Q000592:standards* / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D013923:Thromboembolism / Q000188:drug therapy*
D000925:Anticoagulants