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. 2023 Aug 7;7(6):102168.
doi: 10.1016/j.rpth.2023.102168. eCollection 2023 Aug.

Venous thromboembolism prophylaxis for hospitalized adult patients: a survey of US health care providers on attitudes and practices

Barbara D Lam  1 , Laura E Dodge  2   3 , Siddhant Datta  4 , Rachel P Rosovsky  5   6 , William Robertson  7   8 , Leslie Lake  7 , Nimia Reyes  9 , Alys Adamski  9 , Karon Abe  9 , Samuel Panoff  1 , Amanda Pinson  1 , Pavania Elavalakanar  1 , Ioannis S Vlachos  6   10   11 , Jeffrey I Zwicker  12 , Rushad Patell  1   6
Affiliations

Venous thromboembolism prophylaxis for hospitalized adult patients: a survey of US health care providers on attitudes and practices

Barbara D Lam et al. Res Pract Thromb Haemost. .

Abstract

Background: Venous thromboembolism (VTE) is a leading cause of preventable mortality among hospitalized patients, but appropriate risk assessment and thromboprophylaxis remain underutilized or misapplied.

Objectives: We conducted an electronic survey of US health care providers to explore attitudes, practices, and barriers related to thromboprophylaxis in adult hospitalized patients and at discharge.

Results: A total of 607 US respondents completed the survey: 63.1% reported working in an academic hospital, 70.7% identified as physicians, and hospital medicine was the most frequent specialty (52.1%). The majority of respondents agreed that VTE prophylaxis is important (98.8%; 95% CI: 97.6%-99.5%) and that current measures are safe (92.6%; 95% CI: 90.2%-94.5%) and effective (93.8%; 95% CI: 91.6%-95.6%), but only half (52.0%; 95% CI: 47.9%-56.0%) believed that hospitalized patients at their institution are on appropriate VTE prophylaxis almost all the time. One-third (35.4%) reported using a risk assessment model (RAM) to determine VTE prophylaxis need; 44.9% reported unfamiliarity with RAMs. The most common recommendation for improving rates of appropriate thromboprophylaxis was to leverage technology. A majority of respondents (84.5%) do not reassess a patient's need for VTE prophylaxis at discharge, and a minority educates patients about the risk (16.2%) or symptoms (18.9%) of VTE at discharge.

Conclusion: Despite guideline recommendations to use RAMs, the majority of providers in our survey do not use them. A majority of respondents believed that technology could help improve VTE prophylaxis rates. A majority of respondents do not reassess the risk of VTE at discharge or educate patients about this risk of VTE at discharge.

Keywords: health care surveys; hospitalization; patient discharge; risk assessment; venous thromboembolism.

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Figures

Figure 1
Figure 1
Tools used to determine who needs VTE prophylaxis. A, Tools used to determine need for VTE prophylaxis. B, Tools used to determine bleeding risk. VTE, venous thromboembolism.
Figure 2
Figure 2
Areas for improving VTE prophylaxis. A, Reasons why patients are not on appropriate VTE prophylaxis; this question was asked of 48.0% of respondents who did not perceive that hospitalized patients at their institution were on appropriate prophylaxis almost all of the time. B, Suggestions to improve rates of appropriate VTE prophylaxis. VTE, venous thromboembolism.
See this image and copyright information in PMC

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