title: Improved venous thromboembolism prophylaxis by pharmacist-driven interventions in acutely ill medical patients in Belgium.
abstract: BACKGROUND
  Forty to 50 % of hospitalized patients with an acute medical illness have risk factors for venous thromboembolism (VTE) and it has been shown that VTE prophylaxis reduced the incidence of VTE events in these patients. However, a large multinational survey, the ENDORSE study, showed that only 37 % of medical patients with VTE risk factors actually received VTE prophylaxis.
  
  
  OBJECTIVE
  To evaluate the impact over time of pharmacist-driven interventions aiming at increasing the appropriate use of VTE prophylaxis in acutely ill medical hospitalized patients.
  
  
  METHODS
  A Belgian urban academic hospital.
  
  
  METHODS
  First, during 1 month, medical and nurse reports of all hospitalized medical patients were reviewed to evaluate the proportion of patients who were on prophylaxis according to clinical practice guidelines. Second, interventions were conducted and included unit-specific physician and nurse education, diffusion of educational tools summarizing VTE prophylaxis guidelines, and reminders. Third, the impact of the interventions on the proportion of patients receiving VTE prophylaxis according to clinical practice guidelines was evaluated after 3 months and 1 year.
  
  
  METHODS
  Proportion of hospitalized medical patients receiving VTE prophylaxis according to clinical practice guidelines.
  
  
  RESULTS
  The baseline evaluation showed that 36 % (26/72) of the patients at risk of VTE received VTE prophylaxis according to clinical practice guidelines. Three months and one year after the interventions, 68 % (55/81), and 72 % (58/81) of the patients at risk of VTE received VTE prophylaxis according to clinical practice guidelines. Among patients not at risk of VTE, 15 % (21/141), 8 % (24/290), and 8 % (27/330) respectively at baseline evaluation, 3 months and 1 year after the interventions, received VTE prophylaxis.
  
  
  CONCLUSIONS
  Pharmacist-driven interventions improved the proportion of acutely ill medical patients receiving VTE prophylaxis according to clinical practice guidelines and the benefit of the interventions was maintained after 1 year.
authors.affiliation: Pharmacy, Erasme University Hospital, Route de Lennik 808, 1070, Brussels, Belgium, audrey.vervacke@erasme.ulb.ac.be.
authors.forename: Audrey
authors.initials: A
authors.lastname: Vervacke
authors.forename: Sophie
authors.initials: S
authors.lastname: Lorent
authors.forename: Serge
authors.initials: S
authors.lastname: Motte
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D010595:Pharmacists; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000379:methods*; D024382:Professional Role; D015397:Program Evaluation; D054556:Venous Thromboembolism / Q000517:prevention & control*
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