Evaluation of the adherence of venous thromboembolism prophylaxis with the guideline

Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary thromboembolism, is a condition with increased morbidity and mortality, and the risk can increase 8-fold by hospitalization. Therefore, appropriate VTE risk assessment and initiation of prophylaxis are important in hospitalized patients. The aims of the study were to evaluate; the VTE prophylaxis status of patients hospitalized in internal medicine department (IMD) and emergency department (ED), the role of the clinical pharmacist in VTE management and opinions of physicians about VTE prophylaxis. This study was conducted prospectively (June-December 2022) in the inpatient wards of the IMD of a university hospital, and retrospectively (March-September 2021) in the ED and IMD wards. In the retrospective period, 116 patients from the ED and 300 patients from IMD wards were included; and in the prospective period 353 patients from IMD were included. Eighty-eight percent of ED patients, 41% of IMD ward patients in the retrospective period and 35% of IMD ward patients in the prospective period were found to be at high risk (p<0.001). Considering the patients at high risk of VTE, 51% of patients in the ED and 62% of patients in IMD ward in the retrospective period received appropriate VTE prophylaxis, while this rate was 81% in IMD ward in the prospective period, in which a multidisciplinary work with clinical pharmacist was conducted (p<0.001). Although there was a decrease in the ratio of unnecessary thromboprophylaxis in IMD wards in the prospective period (3%) (5.1% in the retrospective period), no significant difference was found(p=0.428). The main concern for physicians to avoid prophylaxis was the risk of bleeding of anticoagulants (82.5%). In conclusion, multidisciplinary health care will contribute to the improvement of the quality of care provided within the framework of VTE management in accordance with the guidelines.