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  Poster Hall

Sun-3 - Evaluation of Chemoprophylaxis Prescribing Practices in Internal Medicine Patients with Low Clot Risk at a Large Academic Medical Center

Scientific Poster Session II - Residents and Fellows Research-in-Progress

Residents and Fellows Research in Progress
  Sunday, October 13, 2024
  12:45 PM–02:15 PM

Abstract

Introduction: In-hospital venous thromboembolisms (VTEs), including deep venous thromboses (DVT) and pulmonary embolisms (PE), can lead to significant morbidity and mortality. Additional consequences to in-hospital VTEs include increased healthcare expenditures, increased length of stay, and decreased quality of life. Due to the concern for in-hospital VTE consequences, there has been an increase in prescribing chemical prophylaxis, potentially leading to overprescribing. Anticoagulants are not without harm, and can increase the risk for bruising/bleeding, injection site reactions, and overall patient discomfort.

Organizations have recommended utilizing a risk-assessment model (RAM) to identify patients as low, moderate, or high risk of developing an in-hospital VTE. The goal of this model is to identify patients who may or may not require VTE prophylaxis (chemical or mechanical). Despite the risk-stratification classifications to minimize universal prescribing patterns, there are still many patients prescribed prophylaxis who may not need it. Due to these overprescribing practices despite RAM systems in place, our institution sought to evaluate our prescribing practices for chemical prophylaxis in low-risk stratified patients.

Research Question or Hypothesis: The goal of this study was to assess the chemical prophylaxis prescribing patterns in low-risk patients admitted to the Nebraska Medicine Internal Medicine teaching teams.

Study Design: Single-center, retrospective, observational study

Methods: This study includes adults individuals = 19 years old who were admitted to the Nebraska Medicine Internal Medicine teams. Patients were included if they were discharged between January 1, 2024 and June 30, 2024, considered low-risk for chemical prophylaxis (Caprini score 0-2), and received enoxaparin for chemical prophylaxis. Outcomes evaluated included the percentage of patients with a low-risk score who were either prescribed or not prescribed chemical prophylaxis, hospital length of stay, drug costs, and incidences of bleeding and thrombosis. Descriptive statistics will be used to analyze the data as indicated.

Results: In-progress

Conclusion: In-progress

Presenting Author

Madeline Shaffer PharmD
Nebraska Medicine

Authors

Casey Behnke MD
Nebraska Medicine

Zachary Brodie DO
Nebraska Medicine

Erin Cooke MD
Nebraska Medicine

Sara Kjerengtroen PharmD, BCPS
Nebraska Medicine

Emilie Langenhan PharmD, BCPS, CACP
Nebraska Medicine

Ashton Neylon MD
Nebraska Medicine

Carrie Valenta MD, FHM, FACP
Nebraska Medicine