Scientific Poster Session I - Students Research-in-Progress

Students Research in Progress
  Saturday, October 12, 2024
  11:30 AM–01:00 PM

Abstract

Introduction: Venous thromboembolism (VTE) is a common and preventable complication of hospitalization due to increased immobility, trauma, infection, and surgery. Prophylactic anticoagulation is recommended in guidelines for medical patients at an increased risk of developing VTE. For chemoprophylaxis, subcutaneous enoxaparin, a low-molecular-weight heparin (LMWH), is commonly used due to its predictable pharmacokinetics. While standard fixed prophylaxis dosing regimens, for example 30mg twice daily or 40mg daily, are often indicated, dose adjustments may be warranted based on renal function and body mass index (BMI). Institutional data at Nebraska Medicine found adjustments for renal dysfunction or reduced and elevated BMI were not being routinely made. In response, an enoxaparin indication-based order panel was implemented in December 2021 that auto-populates recommended dosing based on patient-specific creatinine clearance and BMI to enhance prescribing decision support.

Research Question or Hypothesis: This study was aimed at evaluating the effectiveness and safety of implementing an enoxaparin indication-based order panel for VTE prophylaxis on appropriate prescribing for VTE chemoprophylaxis in non-surgical, non-trauma medical patients.

Study Design: Retrospective chart review, single-center, medication use evaluation.

Methods: This study was conducted at Nebraska Medicine, a large academic medical center. It included non-surgical adult patients who received enoxaparin for VTE prophylaxis for calendar year 2023. Data were pulled from the electronic health record (N = 4652 patient encounters), and a random sample was achieved by selecting every twenty-third patient with a target sample of 200 patients. Exclusion criteria included therapeutic or weight-based enoxaparin dosing, the use of other parenteral anticoagulation agents for VTE prophylaxis, diagnosis of heparin-induced thrombocytopenia, and active malignancy. Outcomes assessed include compliance with the enoxaparin order panel, incidence of VTE or bleeding events, and hospital length of stay. Whether order decision support came from an order set or indication-based panel will also be assessed. Descriptive statistics will be used to evaluate data.

Results: In-progress

Conclusion: In-progress

Presenting Author

Theodore Blum PharmD Candidate
Nebraska Medicine

Authors

Sara Kjerengtroen PharmD, BCPS
Nebraska Medicine

Emilie Langenhan PharmD, BCPS, CACP
Nebraska Medicine

Sarah Sindelar PharmD
Nebraska Medicine