Prevention of Venous Thromboembolism: Practice Patterns in 17 Geographically Diverse Long Term Care Facilities in the United States: Part 1 of 2 (an AMDA Foundation Project)

T. S. Dharmarajan, Aman Nanda, Bikash Agarwal, Parag Agnihotri, G. L. Doxsie, Murthy Gokula, Ashkan Javaheri, M. Kanagala, Anna S. Lebelt, Prasuna Madireddy, Sourya Mahapatra, P. Murakonda, Ram Rao S. Muthavarapu, Mennakshi Patel, Christopher Patterson, Kathleen Soch, Anna Troncales, Kamal Yaokim, Robin Kroft, Edward P. Norkus

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Introduction: Current guidelines recommend antithrombotic prophylaxis for venous thromboembolism (VTE) using risk assessment, factoring contraindications. This report represents a summary of current practice patterns to prevent VTE in long term care as Phase 1 of a 3-phase educational intervention study. Phase 1 Participants: Participants were 376 new admissions/readmissions (77 ± 12 [SD] years; 67% female) from 17 geographically diverse long term care facilities (3260 total beds). Measurements: The process describes current VTE prophylaxis (VTE-P) practices; a companion article describes the educational intervention (Phase 2) and outcome (Phase 3). Phase 1 data were collected on use of nonpharmacological measures and antithrombotic drugs for VTE-P between July and September 2009. Results: Indications for VTE-P were evident in 85% of new admissions, of which two-thirds received VTE-P. Contraindications for anticoagulation were observed in 54.8% of admissions, including quality of life or patient/caregiver wishes. Logistic regression analysis predicted no relationship between any indication for or any contraindication to VTE-P and use of VTE-P, suggesting an inadequate understanding of current clinical practice guidelines. Conclusions: Residents of long term care have significant comorbidity that poses risk for VTE; although many received VTE-P, contraindications were common, warranting individualized considerations. The likelihood of VTE-P was greatest following orthopedic surgery, severe trauma, and medical illness.

Original languageEnglish (US)
Pages (from-to)298-302
Number of pages5
JournalJournal of the American Medical Directors Association
Volume13
Issue number3
DOIs
StatePublished - Mar 2012

Keywords

  • DVT
  • Mechanical measures to prevent VTE
  • Pulmonary embolism
  • VTE prophylaxis
  • Venous thromboembolism
  • Venous thromboembolism prophylaxis in LTC

ASJC Scopus subject areas

  • Nursing(all)
  • Health Policy
  • Geriatrics and Gerontology

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    Dharmarajan, T. S., Nanda, A., Agarwal, B., Agnihotri, P., Doxsie, G. L., Gokula, M., Javaheri, A., Kanagala, M., Lebelt, A. S., Madireddy, P., Mahapatra, S., Murakonda, P., Muthavarapu, R. R. S., Patel, M., Patterson, C., Soch, K., Troncales, A., Yaokim, K., Kroft, R., & Norkus, E. P. (2012). Prevention of Venous Thromboembolism: Practice Patterns in 17 Geographically Diverse Long Term Care Facilities in the United States: Part 1 of 2 (an AMDA Foundation Project). Journal of the American Medical Directors Association, 13(3), 298-302. https://doi.org/10.1016/j.jamda.2011.04.016