The role of pharmacists in quality management of venous thromboembolism: a retrospective, observational, single-center study in the cardiothoracic surgery department

Background: Venous thromboembolism (VTE) prophylaxis frequently falls short of ideal standards in current clinical practice. Based on China's policy-oriented quality evaluation indicators for VTE management, this study explored the role of pharmacists in VTE prophylaxis quality management and conducted preliminary verification among cardiothoracic surgery inpatients. Methods: We retrospectively analyzed patients hospitalized in the cardiothoracic surgery department of our hospital between 1 January 2025 and 30 June 2025. The primary outcome measures included the implementation rates of pharmacological, mechanical, combined, and standardized prophylaxis. The secondary outcomes included the incidence of hospital-associated VTE, in-hospital major bleeding events, and the mortality attributable to hospital-associated VTE. Patients were categorized into the baseline group, pilot intervention group, and pharmacist intervention group based on the time series and the extent of pharmacist involvement. We compared the outcome measures for each group within both the original study cohort and the propensity score matching (PSM) cohort. We also performed stratified analyses by baseline VTE risk category (moderate vs. high risk) to assess potential effect modification. Results: A total of 1813 patients were enrolled in this study, with a mean age of 62.1 ± 11.8 years. Among them, 1171 (64.6%) were identified as being at moderate or high risk of VTE. Progressive pharmacist intervention coincided with increases in the implementation of mechanical prophylaxis (54.6% vs. 74.2% vs. 79.7%, p < 0.001, Cramer's V = 0.224, 95% CI [0.182, 0.266])) and standardized prophylaxis (57.1% vs. 74.8% vs. 77.8%, p < 0.001, Cramer's V = 0.188, 95% CI [0.146, 0.228]) compared to the baseline period. Conversely, no statistically significant alterations were observed in the rates of pharmacological (43.9% vs. 45.7% vs. 49.1%, p = 0.351) and combined prophylaxis implementation (70.7% vs. 70.3% vs. 69.5%, p = 0.976). This finding was corroborated by the PSM cohort. The reduction in hospital-associated VTE were observed, though the analysis was based on very few events (9 vs. 1), which limits interpretability. Conclusion: The pharmacist-participated VTE management model was associated with improved implementation rates of mechanical and standardized prophylaxis, generating hypotheses about its potential utility in optimizing quality control for in-hospital VTE prevention and management, which remain to be validated through concurrent controlled trials.