Standardized direct oral anticoagulants prescription for treatment of acute venous thromboembolism in the emergency department: A quality improvement initiative.

Direct oral anticoagulants Medication appropriateness Quality improvement Venous thromboembolism

Journal

Thrombosis research
ISSN: 1879-2472
Titre abrégé: Thromb Res
Pays: United States
ID NLM: 0326377

Informations de publication

Date de publication:
16 Feb 2024
Historique:
received: 20 12 2023
revised: 30 01 2024
accepted: 14 02 2024
medline: 25 2 2024
pubmed: 25 2 2024
entrez: 24 2 2024
Statut: aheadofprint

Résumé

Direct oral anticoagulants (DOACs) are commonly used for the treatment and prevention of venous thromboembolism (VTE). However, prescription errors with DOACs can lead to patient dissatisfaction and harm. This study aimed to evaluate the impact of a standardized prescription for DOACs for VTE on prescription appropriateness. The study included patients discharged from the Emergency Department (ED) with a DOAC prescription for an acute VTE. A standardized prescription tool was developed and implemented, and patients were divided into pre- and post-intervention groups. The appropriateness of prescriptions was assessed using the Medication Appropriateness Index (MAI). A total of 161 patients with VTE were included in the study. The post-intervention group showed a significant increase in prescriptions with an MAI rating of "appropriate" and a decrease in ratings of "inappropriate." Improvements were observed in loading dose duration, maintenance dose frequency and duration, and inclusion of necessary drug coverage codes. The implementation of a standardized prescription for DOACs in the management of VTE in the ED significantly improved medication appropriateness and reduced inappropriate prescriptions. Standardized prescriptions have the potential to enhance patient safety and optimize care by providing clear and uniform guidance to healthcare providers. Further research is needed to explore the effectiveness of medication prescription software systems in real-world clinical settings to improve prescribing practices.

Identifiants

pubmed: 38401355
pii: S0049-3848(24)00050-1
doi: 10.1016/j.thromres.2024.02.015
pii:
doi:

Types de publication

Letter

Langues

eng

Sous-ensembles de citation

IM

Pagination

68-73

Informations de copyright

Copyright © 2024 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Camille Simard reports financial support was provided by Pfizer Canada Inc. Camille Simard reports financial support was provided by CanVECTOR. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

C Simard (C)

Division of General Internal Medicine, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; Centre of Excellence in Thrombosis and Anticoagulation, Jewish General Hospital, McGill University, Montreal, Quebec, Canada. Electronic address: camille.simard@mcgill.ca.

L Poirier-Blanchette (L)

Department of Medicine, McGill University, Montreal, Quebec, Canada.

A Rizzolo (A)

Department of Medicine, McGill University, Montreal, Quebec, Canada.

T Cafaro (T)

Division of General Internal Medicine, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

R Kerzner (R)

Department of Pharmacy, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

H Mantzanis (H)

Department of Pharmacy, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

M Koolian (M)

Division of General Internal Medicine, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; Centre of Excellence in Thrombosis and Anticoagulation, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

Classifications MeSH