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Poor Adherence to Risk Stratification Guidelines Results in Overuse of Venous Thromboembolism Prophylaxis in Hospitalized Older Adults
Author(s) -
Pavon Juliessa M.,
Sloane Richard J.,
Pieper Carl F.,
ColónEmeric Cathleen S.,
Cohen Harvey J.,
Gallagher David,
Morey Miriam C.,
McCarty Midori,
Ortel Thomas L.,
Hastings Susan N.
Publication year - 2018
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.12788/jhm.2916
Subject(s) - medicine , gerontology , veterans affairs , family medicine
Venous thromboembolism (VTE) prophylaxis is an important consideration for every older adult admitted to the hospital1 but should not be prescribed to all patients. Use of anticoagulants (specifically low-molecular-weight heparin, low-dose unfractionated heparin, and fondaparinux) when not medically indicated may be harmful, especially for older adults who on average have more chronic conditions,1 take more potentially interacting medications,2 and have higher risks of bleeding.3 The American College of Chest Physicians (ACCP) Ninth Edition Guidelines for Antithrombotic Therapy and Prevention of Thrombosis explicitly recommend a risk-stratification approach using the Padua Prediction Score (PPS) to select those patients most likely to benefit from VTE prophylaxis.4,5 This study aimed to describe the use of risk stratification and pharmacologic VTE prophylaxis use in a population of medically ill, hospitalized older patients.