Key result
Clinical pharmacist services for total joint arthroplasty improved anticoagulation management but did not significantly reduce the incidence of symptomatic DVT at up to 3 months follow-up (p>0.05).
Why the study?
Thrombosis incidence remains high in total joint arthroplasty despite conventional antithrombotic therapy, and the roles and functions of clinical pharmacists in orthopaedic multidisciplinary teams are not yet defined.
Does clinical pharmacist intervention improve anticoagulation management and reduce thrombosis in patients undergoing total joint arthroplasty?
Cohort (n=577)
Does clinical pharmacist intervention improve anticoagulation management and reduce thrombosis in patients undergoing total joint arthroplasty?
p-value: p=>0.05
Clinical pharmacist intervention in total joint arthroplasty improves anticoagulation management processes, though it did not significantly reduce symptomatic DVT incidence in this retrospective cohort.
Pharmacist-led anticoagulation management in joint arthroplasty improves processes but not symptomatic DVT; supports targeted protocols yet leaves outcome benefits open for prospective trials.
WHAT IS KNOWN AND OBJECTIVE: Even if total joint arthroplasty (TJA) patients have received conventional antithrombotic therapy, the incidence of thrombosis remains high. Clinical pharmacists have been involved in the multidisciplinary team of orthopaedics, but their roles and functions are not yet defined. The objective of this study was to assess the impact of clinical pharmacist services on the use of anticoagulant drugs, the rationality of medication and the incidence of thrombosis in patients with TJA. METHODS: This retrospective, observational cohort study was conducted for patients undergoing TJA procedures. Study variables were collected for a baseline period of 1 January 2016 to 30 June 2017 and an intervention period of 1 January 2018 to 30 June 2019, allowing for a 6-month run-in period. For demographic characteristics, the use of anticoagulant drugs and the incidence of thrombosis between the baseline and intervention periods, the data were statistically analysed. RESULTS AND DISCUSSION: During the 36-month study timeframe, a total of 591 TJA procedures were performed. A total of 577 participants were included in the study (240 in the baseline group and 377 in the intervention group). After clinical pharmacist participation, the prevention rate of anticoagulant drugs (p < 0.05), the proportion of oral anticoagulants (p = 0.000) and the course of preventive treatment (p = 0.004) increased significantly. The time of administration was shortened from after 24 h to within 24 h post-surgery (p = 0.000). Although the incidence of symptomatic DVT reduced in the intervention period, there was no statistical difference in either the hospital, 1-month follow-up, or 3-month follow-up after surgery (all p > 0.05). WHAT IS NEW AND CONCLUSION: Within the limitations of a retrospective study, clinical pharmacist intervention was associated with improvements in anticoagulation management of TJA procedures, likely conferring beneficial effects.
No takes yet. Share an insight, caveat, or question.
Shang et al. (2021) conducted a cohort in Total joint arthroplasty (n=577). Clinical pharmacist services vs. Baseline period (no clinical pharmacist services) was evaluated on Use of anticoagulant drugs, rationality of medication, and incidence of symptomatic deep vein thrombosis (DVT) (p=>0.05). Clinical pharmacist services for total joint arthroplasty improved anticoagulation management but did not significantly reduce the incidence of symptomatic DVT at up to 3 months follow-up (p>0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: