What is the clinical evidence from this study?

Study design: Cohort. Population: Deep venous thrombosis and pulmonary embolism (n=194). Intervention: Self-injection of dalteparin vs. Homecare nurse administration of dalteparin. Primary outcome: Recurrent venous thromboembolism (p=>.99).

What does this research mean for the field?

Outpatient self-injection of dalteparin for deep vein thrombosis and pulmonary embolism yields similar rates of recurrent venous thromboembolism and bleeding compared to nurse administration, enabling the safe expansion of outpatient treatment eligibility. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

September 14, 1998Archives of Internal Medicine

Expanding Eligibility for Outpatient Treatment of Deep Venous Thrombosis and Pulmonary Embolism With Low-Molecular-Weight Heparin

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Key result

Outpatient self-injection of dalteparin for DVT and pulmonary embolism yielded similar rates of recurrent venous thromboembolism compared to nurse administration (4.0% vs 3.2%, P>.99).

Why the study?

Does patient self-injection compared with homecare nurse administration affect the safety and effectiveness of outpatient dalteparin treatment in patients with deep vein thrombosis and pulmonary embolism?

Population

194 outpatients with deep vein thrombosis and pulmonary embolism. Excluded: massive pulmonary embolism, high…

Comparison

Outpatient treatment with dalteparin sodium and… vs Same outpatient treatment with dalteparin and…

Design

Cohort

Follow-up

3 months

Authors

PWPhilip S. WellsUniversity of Ottawa MKMichael J. KovacsVascular Medicine JBJanis BormanisOttawa Hospital

Discussion

Member takes

Implication

Patient self-injection may offer a convenient dalteparin option in selected outpatients; leaves open need for randomized confirmation before broader adoption.

Study Design

Type

Cohort (n=194)

Multicenter

Structured PICO

Population

194 outpatients with deep vein thrombosis and pulmonary embolism. Excluded: massive pulmonary embolism, high risk for major bleeding or active bleed, phlegmasia, and patients hospitalized for reasons preventing discharge.

Intervention

Outpatient treatment with dalteparin sodium (200 U/kg every 24 hours for a minimum of 5 days) and warfarin, with patients taught to inject themselves.

Comparator

Same outpatient treatment with dalteparin and warfarin, but injections administered by homecare nurses.

Outcome

Rate of recurrent venous thromboembolism at 3 months follow-up.hard clinical

Main Result

Absolute Event Rate: 4% vs 3.2%

p-value: p=>.99

Expanding outpatient treatment of DVT and PE using dalteparin is feasible and safe, with self-injection being as effective as nurse-administered injection.

Cite This Study

Wells et al. (1998) conducted a cohort in Deep venous thrombosis and pulmonary embolism (n=194). Self-injection of dalteparin vs. Homecare nurse administration of dalteparin was evaluated on Recurrent venous thromboembolism (p=>.99). Outpatient self-injection of dalteparin for DVT and pulmonary embolism yielded similar rates of recurrent venous thromboembolism compared to nurse administration (4.0% vs 3.2%, P>.99).

synapsesocial.com/papers/6a15867f79ff98d0de4ec28c https://doi.org/10.1001/archinte.158.16.1809

Topics

Pulmonary embolism

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Implication

Patient self-injection may offer a convenient dalteparin option in selected outpatients; leaves open need for randomized confirmation before broader adoption.

Expanding Eligibility for Outpatient Treatment of Deep Venous Thrombosis and Pulmonary Embolism With Low-Molecular-Weight Heparin

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Expanding Eligibility for Outpatient Treatment of Deep Venous Thrombosis and Pulmonary Embolism With Low-Molecular-Weight Heparin

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider