title: [Venous thromboprophylaxis in medical patients: an application review].
abstract: OBJECTIVE
  Routine thromboprophylaxis, despite its well-known effectiveness and the fact that venous thromboembolism is a potentially avoidable condition, is not fully established in clinical practice. The objectives of the present study were to determine how often thromboprophylaxis is used and the presence of thromboembolism risk factors, and to verify the appropriateness of its use in medical inpatients, assuming a long-standing national guideline as a parameter.
  
  
  METHODS
  This was a retrospective cross-sectional study, involving inpatients with medical conditions in the adult general ward of a university hospital. The review was based on a defined guideline.
  
  
  RESULTS
  146 patients were included in the review. At least one risk factor for venous thromboembolism was found in 94.5%. In 130 (89%) patients, prophylactic heparin was indicated, and some kind of heparin was prescribed in 73.3%. Regarding the adequacy of prophylaxis, 53.4% of prescriptions were correct regarding prophylaxis indication and dose; 24% had incorrect dose or frequency of use; 19.2% had no prophylaxis prescription, although it was indicated; and in five cases (3.4%), the drug was prescribed, even though it was not indicated.
  
  
  CONCLUSIONS
  Thromboprophylaxis is underused in this population, and an inappropriate dose was prescribed in 50% of cases. Therefore, future studies and interventions should include an educational program started from the emergency department care, an essential step to bring evidence closer to clinical practice.
authors.affiliation: Departamento de Clínica Médica, Escola Paulista de Medicina, Universidade Federal de São Paulo EPM/UNIFESP, São Paulo, SP, Brasil.
authors.forename: Mariana Nassif
authors.initials: MN
authors.lastname: Kerbauy
authors.forename: Fabio Ynoe
authors.initials: FY
authors.lastname: de Moraes
authors.forename: Lucila Nassif
authors.initials: LN
authors.lastname: Kerbauy
authors.forename: Lucieni de Oliveira
authors.initials: Lde O
authors.lastname: Conterno
authors.forename: Silene
authors.initials: S
authors.lastname: El-Fakhouri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006493:Heparin / Q000627:therapeutic use*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic / Q000592:standards; D012189:Retrospective Studies; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D000925:Anticoagulants; D006493:Heparin