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Venous thromboembolism prevention program — the evidence base

Various reports have presented data on current practice in relation to the prevention of venous thromboembolism (VTE) in hospitalised patients. NICS sought more comprehensive data on the overall magnitude of the problem from the University of Western Australia using the unique advantages of the Western Australian data linkage system.

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Incidence and risk factors for VTE in Western Australian hospitals

NICS commissioned the School of Population Health at the University of Western Australia to undertake a study of the incidence, risk factors and trends in the incidence of VTE in Western Australian hospitals. This study included determining the prevalence of use of VTE prophylaxis measures in high risk surgical and medical patients.

Key findings

  • VTE cases in acute hospitals are equally attributable to medical (40 per cent) or surgical admissions (40 per cent), with primary VTE accounting for the remaining cases
  • Over 50 per cent of secondary cases of VTE in acute hospitals occur as re-admissions within three months of a medical or surgical admission
  • The rate of VTE cases in acute hospitals has continued to increase over the last ten years
  • There is great variation in the use of chemoprophylaxis in patients at high risk of VTE

Copies of the reports arising from this study can be found via the following links:

Interventions to improve uptake of venous thromboembolism prophylaxis in hospitals

To assess the effectiveness of different strategies for increasing the uptake of prophylaxis for VTE in hospitalised patients, NICS commissioned a systematic review of the literature from the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S) of the Royal Australasian College of Surgeons.

Key findings

  • Passive dissemination strategies are ineffective at improving VTE prevention
  • Multiple active strategies which incorporate reminders for clinicians to assess patients for VTE risk and assist in the selection of appropriate prophylactic measures are more likely to result in improvements.

Key recommendation

  • To effect change in VTE prophylaxis practice requires clinical leadership, improved clinician knowledge of risk assessment and appropriate prescribing, and a supportive system which embeds VTE prophylaxis into routine care processes.

The findings of this study are available in the report Interventions to improve uptake of venous thromboembolism prophylaxis in hospitals, published in the Annals of Surgery Volume 241: 397-415; March 2005.

 

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