Effectiveness of a medical education programme and an electronic alert system to increase the proper use of anti-thrombotic prophylaxis in hospitalized patients

Abstract

Background: Antithrombotic prophylaxis in hospitalized patients at risk of venous thromboembolic disease (VTE) is often overlooked. Objective: To evaluate the effectiveness of an educational program and an electronic alert on antithrombotic prophylaxis utilization in hospitalized patients at risk of VTE. Design: Quasi-experimental uncontrolled pre- and post-intervention study. Patients: ≥18 years, both genders with prophylaxis indication, and hos-pitalized ≥72 hours in 2009 (pre-intervention), 2016 (post-education), and 2017 (post-alert). Methods: We calculated crude and adjusted odds ratios (OR) for age, sex, patient type, and VTE risk factors for the association between antithrombotic prophylaxis use and interventions. Results: We included 239 patients (80 pre-intervention, 80 post-education, and 79 post-alert). Prophylaxis utilization increased from 66.2% pre-intervention to 90% post-alert. The post-alert group had 3.6 times higher odds of receiving prophylaxis in adjusted analysis (OR: 3.6, 95% CI: 1.4–9.1). Interventions did not significantly alter prophylaxis use in medical patients. Conclusions: An educational program and an electronic alert are effective in increasing antithrombotic prophylaxis utilization in hospitalized patients, with particular benefit in surgical patients.

Keywords

• alert
• medical records
• patient safety
• primary prevention
• pulmonary embolism
• reminder systems
• venous thrombosis