Key result
A clinical pharmacist intervention using risk assessment models significantly increased the rate of venous thromboembolism prophylaxis prescription in high-risk renal-impaired patients from 34.8% to 100%.
Why the study?
The role of the clinical pharmacist in improving venous thromboembolism prophylaxis prescription in patients with renal impairment needed evaluation.
Does a clinical pharmacist intervention improve the rate of appropriate VTE prophylaxis prescription in hospitalized patients with renal impairment?
Cross-Sectional (n=123)
No
Does a clinical pharmacist intervention improve the rate of appropriate VTE prophylaxis prescription in hospitalized patients with renal impairment?
Absolute Event Rate: 100% vs 34.8%
p-value: p=<0.001
A clinical pharmacist intervention using risk assessment models significantly improves appropriate VTE prophylaxis prescribing in hospitalized patients with renal impairment.
May support pharmacist-led VTE prophylaxis in renal impairment; leaves open confirmation via randomized trials.
OBJECTIVES: To evaluate the role of the clinical pharmacist in improving venous thromboembolism (VTE) prophylaxis prescription in patients with renal impairment (RI). METHODS: This was an interventional cross-sectional study conducted in a nephrology ward. Patients' risk scores for VTE and bleeding during hospitalisation (evaluated by the Caprini Risk Assessment Model (RAM), Padua Prediction Score and IMPROVE Bleeding Risk Score, respectively), and the rate of VTE prophylaxis administration to patients, were evaluated before and after a clinical pharmacist's intervention. RESULTS: In the pre-intervention phase, 34.8% of high-VTE-risk patients, of whom 12.5% were also at high risk of bleeding, received pharmacological prophylaxis. Moreover, 22.2% of low-VTE-risk patients received prophylaxis. In the intervention phase, prophylaxis was administered to all high-risk patients (mechanical prophylaxis in 7% of patients with a high risk of both VTE and bleeding, and heparin in the remainder) and to 3.3% of those at low risk of VTE. CONCLUSIONS: The clinical pharmacist's intervention using RAMs can improve the rate of thrombosis prophylaxis prescription in patients with RI who have a high risk of VTE.
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Nikvarz et al. (2019) conducted a cross-sectional in Renal impairment (n=123). Clinical pharmacist intervention using Risk Assessment Models (RAMs) vs. Pre-intervention phase (standard care) was evaluated on Rate of VTE prophylaxis administration in high-VTE-risk patients (p=<0.001). A clinical pharmacist intervention using risk assessment models significantly increased the rate of venous thromboembolism prophylaxis prescription in high-risk renal-impaired patients from 34.8% to 100%.
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