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Prevention of venous thromboembolism: practice patterns in 17 geographically diverse long term care facilities in the United States: part 1 of 2 (an AMDA Foundation project).

Abstract：

INTRODUCTION:Current guidelines recommend antithrombotic prophylaxis for venous thromboembolism (VTE) using risk assessment, factoring contraindications. This report represents a summary of current practice patterns to prevent VTE in long term care as Phase 1 of a 3-phase educational intervention study. PHASE 1 PARTICIPANTS:Participants were 376 new admissions/readmissions (77 ± 12 [SD] years; 67% female) from 17 geographically diverse long term care facilities (3260 total beds). MEASUREMENTS:The process describes current VTE prophylaxis (VTE-P) practices; a companion article describes the educational intervention (Phase 2) and outcome (Phase 3). Phase 1 data were collected on use of nonpharmacological measures and antithrombotic drugs for VTE-P between July and September 2009. RESULTS:Indications for VTE-P were evident in 85% of new admissions, of which two-thirds received VTE-P. Contraindications for anticoagulation were observed in 54.8% of admissions, including quality of life or patient/caregiver wishes. Logistic regression analysis predicted no relationship between any indication for or any contraindication to VTE-P and use of VTE-P, suggesting an inadequate understanding of current clinical practice guidelines. CONCLUSIONS:Residents of long term care have significant comorbidity that poses risk for VTE; although many received VTE-P, contraindications were common, warranting individualized considerations. The likelihood of VTE-P was greatest following orthopedic surgery, severe trauma, and medical illness.

journal_name

J Am Med Dir Assoc

journal_title

Journal of the American Medical Directors Association

authors

Dharmarajan TS,Nanda A,Agarwal B,Agnihotri P,Doxsie GL,Gokula M,Javaheri A,Kanagala M,Lebelt AS,Madireddy P,Mahapatra S,Murakonda P,Muthavarapu SR,Patel M,Patterson C,Soch K,Troncales A,Yaokim K,Kroft R,Norkus EP

doi

10.1016/j.jamda.2011.04.016

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

298-302

issue

eissn

1525-8610

issn

1538-9375

pii

S1525-8610(11)00144-7

journal_volume

pub_type

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Prevention of venous thromboembolism: practice patterns in 17 geographically diverse long term care facilities in the United States: part 1 of 2 (an AMDA Foundation project).