Sticker reminders improve thromboprophylaxis appropriateness in hospitalized patients.
BACKGROUND
Venous thromboembolism (VTE) is a major health problem. Even though effective thromboprophylaxis measures exist to prevent VTE, close adherence to guidelines is missing. We assessed the effects of pasting VTE prophylaxis sticker reminders, on the appropriateness of thromboprophylaxis and prophylaxis underutilization.


METHODS
Thromboprophylaxis reception was sought prospectively in two time points before and two time points after pasting sticker reminders in hospitalized patients of Masih Daneshvari Medical Center, Tehran, Iran. Thromboprophylaxis reception appropriateness was evaluated by the eighth American College of Chest Physicians (ACCP) guidelines on antithrombotic and thrombolytic therapy. Co-morbidities and conditions considered to affect the risk of venous thromboembolism were also recorded.


RESULTS
Prophylaxis reception and appropriateness were studied in 298 patients before and 306 patients after the intervention. Based on the ACCP guidelines, overall thromboprophylaxis appropriateness was improved after the intervention (70.4% before, and 78.1% after the intervention, P=0.03). Prophylaxis underutilization, and prophylaxis initiation delay in those who needed thromboprophylaxis, were also reduced (P=0.03, and P=0.011 respectively). The intervention did not result in an increased rate of overprophylaxis (P=0.45).


CONCLUSIONS
Sticker reminders could be safely and effectively incorporated into strategies to improve VTE prophylaxis and prophylaxis appropriateness, particularly in healthcare settings where electronic alert systems are not available.
Sharif-Kashani
Babak
B
Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Disease (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University MC, Tehran, Iran.
Raeissi
Sasan
S
Bikdeli
Behnood
B
Shahabi
Payman
P
Behzadnia
Neda
N
Saliminejad
Leila
L
Samiei-Nejad
Mojgan
M
Nasiri
Fatemeh
F
Khayyami
Maryam
M
Forootan
Batool
B
Pozhan
Saviz
S
Masjedi
Mohammad-Reza
MR
D016009:Chi-Square Distribution; D004363:Drug Utilization; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D019983:Guideline Adherence; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007492:Iran; D016015:Logistic Models; D008499:Medical Records / Q000706:statistics & numerical data; D008510:Medication Systems, Hospital / Q000706:statistics & numerical data; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D017010:Reminder Systems / Q000706:statistics & numerical data; D013997:Time Factors; D054556:Venous Thromboembolism / Q000517:prevention & control*
D005343:Fibrinolytic Agents