An audit of 8 centres' use of anticoagulant therapies when discharging patients from hospital with Acute Venous Thromboembolism
Canadian Pharmacists Conference ePoster Library. Brocklebank C. 06/25/16; 132131; 10
Dr. Cynthia Brocklebank
Dr. Cynthia Brocklebank
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OBJECTIVES: To report anticoagulant (AC) therapies patients receive for acute venous thromboembolism (VTE) upon hospital discharge.,METHODS: This retrospective chart review from April 2014 to March 2015 included 4 urban Edmonton hospitals, 2 urban Regina hospitals and 3 rural Alberta hospitals. Patients > 18 years of age who were discharged with a diagnosis of VTE (DVT or PE) that lacked another indication for anticoagulant therapy and had an anticipated lifespan > 3 months were included. We primarily sought to assess the anticoagulant regimen prescribed for patients at hospital discharge and with whom follow-up care was to occur. Moreover, we sought to compare differences amongst the urban and rural centres.,RESULTS: After screening 1,047 patients, 692 (66.1%) were included. The majority of patients discharged from hospital had a PE (Edmonton 84.4%, Regina 81.2%, rural Alberta 63.3%). Novel oral anticoagulants (NOACS) were the most common discharge therapy in rural Alberta (50.0%), followed by warfarin (+/- a parenteral AC) (30.0%). In rural Alberta follow-up most commonly occurred with the GP (66.7%). In Regina, the most common therapy at discharge was warfarin (+/- a parenteral AC (59.0%) followed by a NOAC (23.9%), and a parenteral AC alone (16.2%). In Regina, the majority of follow-up was with the GP (52.1%) or specialist (52.1%). In Edmonton, 40.5% were discharged on warfarin (+/- a parenteral AC), 29.2% a parenteral agent alone, and 28.4% on a NOAC. Follow-up most commonly was with the general practitioner [GP] (29.9%) or VTE clinic (29.1%) in Edmonton.,CONCLUSIONS: The majority discharged after VTE related hospitalizations have PEs, and NOACs are used more commonly in rural Alberta (50%) compared to urban centres (~25%). Depending on the centre, follow-up is either done via the family doctor or through specialists / VTE clinic.,,
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