title: The effect of a continuing medical education program on Venous thromboembolism prophylaxis utilization and mortality in a tertiary-care hospital.
abstract: BACKGROUND
  Venous thromboembolism (VTE) prophylaxis is underutilized for hospitalized patients. The primary objective of this study was to assess the impact of a continuing medical education (CME) program on thromboprophylaxis and VTE-associated mortality in a tertiary-care hospital.
  
  
  METHODS
  This was a retrospective study of all patients admitted to a tertiary-care hospital from 01/07/2009 to 30/06/2010 (after a CME program that aimed at improving VTE prophylaxis) and had confirmed VTE during stay. VTE prophylaxis utilization and associated mortality were assessed in them and compared to those of a similar cohort of patients hospitalized in the previous 12 months.
  
  
  RESULTS
  There were 147 confirmed VTE cases in the study period (surgical: 26.5% and medical: 73.5%). Most (63.9%) VTE patients received prophylaxis after the CME program compared with 36.5% in the previous 12 months (relative risk 1.73; 95% confidence interval, 1.38-2.18; P < 0.001). More surgical (82.1%) than medical (57.4%) patients received prophylaxis (P < 0.01). VTE-associated mortality rate was 10.9% with a significant decrease after the CME program (relative risk, 0.52; 95% confidence interval, 0.30-0.90). This mortality was lower for those who received VTE prophylaxis compared to those who didn't (4.3% and 22.6%, respectively; P < 0.01). Additionally, VTE-associated deaths represented 1.1% of total hospital mortality compared to 1.9% in the 12 months before CME program (relative risk, 0.58; 95% confidence interval, 0.32-1.04; P = 0.07).
  
  
  CONCLUSIONS
  A CME educational program to improve VTE prophylaxis in a tertiary-care hospital was associated with improvement in VTE prophylaxis utilization and VTE-associated mortality. Such programs are highly recommended.
authors.affiliation: Department of Intensive Care, King Abdul-Aziz Medical City; College of Medicine, King Saud Bin Abdul-Aziz University for Health Sciences, National Guard Health Affairs, Jeddah, Saudi Arabia ; Saudi Association for Venous Thromboembolism (SAVTE), Jeddah, Saudi Arabia.
authors.forename: Fahad
authors.initials: F
authors.lastname: Al-Hameed
authors.affiliation: Department of Intensive Care, King Abdulaziz Medical City and King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Saudi Arabia.
authors.forename: Hasan M
authors.initials: HM
authors.lastname: Al-Dorzi
authors.affiliation: Department of Surgery, Medical College, University of Um Al-Qura, Mekkah, Saudi Arabia.
authors.forename: Essam
authors.initials: E
authors.lastname: Aboelnazer
keywords: Continuing medical education; Deep venous thrombosis; Pulmonary embolism; Thromboprophylaxis; Venous thromboembolism