Why the study?
Does low-molecular-weight heparin improve outpatient management and reduce costs compared to unfractionated heparin in patients with acute venous thromboembolism?
Does low-molecular-weight heparin improve outpatient management and reduce costs compared to unfractionated heparin in patients with acute venous thromboembolism?
LMWH offers a more predictable dose-response and enables outpatient management for DVT, providing a cost-effective and equally safe alternative to UFH for acute venous thromboembolism.
May support outpatient LMWH for DVT to cut costs; leaves open need for updated RCTs in diverse populations.
Anticoagulant drugs represent the therapy of choice for the initial treatment of venous thromboembolism. Unfractionated heparin (UFH) in adjusted doses and low-molecular-weight heparin (LMWH) in fixed doses are equally as effective and safe. Proper use of UFH requires considerable expertise, can cause inconvenience and has limitations. The use of LMWHs has multiple advantages over UFH including a more predictable dose-response and fixed administration dose. These properties make the treatment of suitable patients feasible in an outpatient setting. In two major clinical trials addressing the treatment of deep vein thrombosis, outpatient management with LMWH was associated with a substantial cost reduction compared with inpatient treatment using UFH. Recent studies have also shown that LMWHs are at least as effective and safe as UFH for the treatment of non-critical patients with pulmonary embolism. Whether or not home treatment of pulmonary embolism is feasible and safe remains to be demonstrated.
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Paolo Prandoni (1998) studied this question.
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