Study finds some patients miss multiple doses for VTE prophylaxis

Johns Hopkins researchers found 12% of ordered doses for blood thinners are not administered to trauma patients for venous thromboembolism prophylaxis, with some patients missing multiple doses, according to a recent study in PLOS ONE.

“There appeared to be a lack of understanding about the risks and benefits of blood thinners among patients and medical staff, even though the research is clear that blood thinners are very effective at preventing blood clots,” Kenneth M. Shermock, PharmD, PhD, director of the Center for Medication Quality and Outcomes at Johns Hopkins Hospital, stated in a press release. “Blood clots and their resulting effects are the most common cause of avoidable death for hospitalized patients and we have a medication that can prevent most of these events. But too many patients are not benefitting.”

Shermock and colleagues examined missed doses of unfractioned heparin or enoxaparin totaling 103,160 ordered doses during 10,516 patient visits during a 7-month period, according to the abstract. The researchers analyzed 29 floors, which included 11 medicine floors, 9 surgery floors, 4 neurology floors and 5 intensive care units.

They found 19% of patients missed at least one-fourth of their doses, 8% of patients missed more than one-half of their doses and 5% missed more than three-quarters of their doses. The most common reason for a missed dose was patient or family member refusal.

The researchers noted patients who were on the medicine floors missed 18% of doses, but even on the floors with the highest percentage of missed doses, more than half of patients received 86% of their doses, according to the abstract. Further, 80% of all missed doses comprised 20% of patients who missed at least two doses.

Reference:

Shermock KM. PLOS ONE. 2013;doi:10.1371/journal.pone.0066311.

Disclosure: The authors reported various financial disclosures. Please see the full study for a complete list.