Interventions for Increasing the Use of Thromboprophylaxis in Hospitalized Patients

Summary

A Cochrane review [Abstract] 1 included 13 studies with a total of 35 997 subjects examing interventions to increase the use of measures to prevent the development of blood clots in hospitalized medical and surgical patients.

Alerts were associated with an increase in the proportion of participants who received prophylaxis (RD 21%, 95% CI 15% to 27%; 3 studies, n=5 057, statistical heterogeneity, I² = 75%) and who received appropriate prophylaxis (RD 16%, 95% CI 12% to 20%; 3 studies, n=1 820). Alerts were also associated with a reduction in the rate of symptomatic venous thromboembolism (VTE) at 3 months (RR 64%, 95% CI 47% to 86%; 3 studies, n=5 353). Computer alerts were associated with a reduction in the rate of symptomatic VTE, although there were not enough studies to pool computer alerts and human alerts results separately. Multifaceted interventions were associated with a small increase in the proportion of participants who received prophylaxis (cluster-adjusted RD 4%, 95% CI 2% to 6%; 5 studies, n=9 198). Multifaceted interventions with an alert component were found to be more effective than multifaceted interventions that did not include an alert.