Utilization rates of enoxaparin and heparin in deep venous thrombosis prophylaxis after education and electronic order change at a single institution: a quality improvement study

Despite advantages of low molecular weight heparin (LMWH), enoxaparin over heparin (UFH) for venous thromboembolism (VTE), a hospital’s prescribing trends analysis showed use of each was about equal. In an attempt to increase LMWH over UFH use, electronic medical record (EMR) changes for medical ser...

Full description

Saved in:
Bibliographic Details
Published in:Journal of thrombosis and thrombolysis 2018-11, Vol.46 (4), p.502-506
Main Authors: Hoang, Linda, Islam, Shahidul, Hindenburg, Alexander
Format: Article
Language:English
Subjects:
Anticoagulants
Cardiology
Electronic medical records
Hematology
Heparin
Medicine
Medicine & Public Health
Molecular weight
Prophylaxis
Quality control
Quality improvement
Thromboembolism
Thrombosis
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c372t-5e538dbaa4af2b6b67b6d69b470824794d8533979f9dc5d48b75dc2b9ec1d9463
cites cdi_FETCH-LOGICAL-c372t-5e538dbaa4af2b6b67b6d69b470824794d8533979f9dc5d48b75dc2b9ec1d9463
container_end_page 506
container_issue 4
container_start_page 502
container_title Journal of thrombosis and thrombolysis
container_volume 46
creator Hoang, Linda
Islam, Shahidul
Hindenburg, Alexander
description Despite advantages of low molecular weight heparin (LMWH), enoxaparin over heparin (UFH) for venous thromboembolism (VTE), a hospital’s prescribing trends analysis showed use of each was about equal. In an attempt to increase LMWH over UFH use, electronic medical record (EMR) changes for medical service patients and education via multidisciplinary grand rounds was provided to all services. This was a unique opportunity to study LMWH and UFH use pre and post interventions at our institution. Citrix Pharmacy data was extracted for 3 months pre and post intervention (August 2016–February 2017). Inclusion criteria were age > 18 and LMWH or UFH VTE prophylaxis. Exclusion criteria were one time or duplicate orders and VTE treatment doses. Primary endpoint was hospital services VTE use with focus on medicine service which had both interventions compared to single intervention among all other services. LMWH use increased from 51 to 57.3% (p 
doi_str_mv 10.1007/s11239-018-1727-x
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2092534855</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2092534855</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-5e538dbaa4af2b6b67b6d69b470824794d8533979f9dc5d48b75dc2b9ec1d9463</originalsourceid><addsrcrecordid>eNp1kcuKFTEQhoMoznH0AdxIwI2b1lw7HXcyjBcYcOOAuyadVM_J0J2cSdLDOT6WT2iaHhUEIZCi6qu_kvoReknJW0qIepcpZVw3hHYNVUw1x0doR6XijRLs-2O0I5rpRnIiz9CznG8JIVoT9hSdcUJ5S6jeoZ_XxU_-hyk-BpxMgYzjiCHEozmY5AM2weE9bHE9DuCA72t9ybjsU5yHmH3GhxQP-9NkjjU2Y4GEwS12U10VYAJbUgze4phcLdu9CTeATcEGZx9uJqjqufiyrD3va_ZuMZMvJ-znKn4PM4SCc1nc6Tl6Mpopw4uH-xxdf7z8dvG5ufr66cvFh6vGcsVKI0Hyzg3GCDOyoR1aNbSu1YNQpGNCaeE6yblWetTOSie6QUln2aDBUqdFy8_Rm023zr9bIJd-9tnCNJkA9fs9q-uVXHRSVvT1P-htXFKor1spKhQVbVcpulE2xZwTjP0h-dmkU09Jvxrab4b21dB-NbQ_1p5XD8rLMIP70_HbwQqwDci1VFea_o7-v-ovRVywyQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2091471468</pqid></control><display><type>article</type><title>Utilization rates of enoxaparin and heparin in deep venous thrombosis prophylaxis after education and electronic order change at a single institution: a quality improvement study</title><source>Springer Nature</source><creator>Hoang, Linda ; Islam, Shahidul ; Hindenburg, Alexander</creator><creatorcontrib>Hoang, Linda ; Islam, Shahidul ; Hindenburg, Alexander</creatorcontrib><description>Despite advantages of low molecular weight heparin (LMWH), enoxaparin over heparin (UFH) for venous thromboembolism (VTE), a hospital’s prescribing trends analysis showed use of each was about equal. In an attempt to increase LMWH over UFH use, electronic medical record (EMR) changes for medical service patients and education via multidisciplinary grand rounds was provided to all services. This was a unique opportunity to study LMWH and UFH use pre and post interventions at our institution. Citrix Pharmacy data was extracted for 3 months pre and post intervention (August 2016–February 2017). Inclusion criteria were age &gt; 18 and LMWH or UFH VTE prophylaxis. Exclusion criteria were one time or duplicate orders and VTE treatment doses. Primary endpoint was hospital services VTE use with focus on medicine service which had both interventions compared to single intervention among all other services. LMWH use increased from 51 to 57.3% (p &lt; 0.001) and UFH use decreased from 49 to 42.7% (p &lt; 0.001) for all services. For medicine service, LMWH use increased 52.5–59.6% (p &lt; 0.001) and UFH use decreased 47.5–40.4% (p &lt; 0.001). For other services, LMWH use increased 48.8–53.6% (p = 0.005) and UFH use decreased 51.2–46.4% (p = 0.005). EMR changes and prescribers’ grand rounds education resulted in 7.1% increase of LMWH use for medicine and 4.8% increase for all other services. The net increase (95% CI) in LMWH use in medicine service is 2.3% (− 1.91%, 6.56%) compared to the other services p = 0.281. Future studies are needed to reassess the effects of continued education and outcome of interventions.</description><identifier>ISSN: 0929-5305</identifier><identifier>EISSN: 1573-742X</identifier><identifier>DOI: 10.1007/s11239-018-1727-x</identifier><identifier>PMID: 30136019</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Anticoagulants ; Cardiology ; Electronic medical records ; Hematology ; Heparin ; Medicine ; Medicine &amp; Public Health ; Molecular weight ; Prophylaxis ; Quality control ; Quality improvement ; Thromboembolism ; Thrombosis</subject><ispartof>Journal of thrombosis and thrombolysis, 2018-11, Vol.46 (4), p.502-506</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><rights>Journal of Thrombosis and Thrombolysis is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-5e538dbaa4af2b6b67b6d69b470824794d8533979f9dc5d48b75dc2b9ec1d9463</citedby><cites>FETCH-LOGICAL-c372t-5e538dbaa4af2b6b67b6d69b470824794d8533979f9dc5d48b75dc2b9ec1d9463</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,778,782,27907,27908</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30136019$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hoang, Linda</creatorcontrib><creatorcontrib>Islam, Shahidul</creatorcontrib><creatorcontrib>Hindenburg, Alexander</creatorcontrib><title>Utilization rates of enoxaparin and heparin in deep venous thrombosis prophylaxis after education and electronic order change at a single institution: a quality improvement study</title><title>Journal of thrombosis and thrombolysis</title><addtitle>J Thromb Thrombolysis</addtitle><addtitle>J Thromb Thrombolysis</addtitle><description>Despite advantages of low molecular weight heparin (LMWH), enoxaparin over heparin (UFH) for venous thromboembolism (VTE), a hospital’s prescribing trends analysis showed use of each was about equal. In an attempt to increase LMWH over UFH use, electronic medical record (EMR) changes for medical service patients and education via multidisciplinary grand rounds was provided to all services. This was a unique opportunity to study LMWH and UFH use pre and post interventions at our institution. Citrix Pharmacy data was extracted for 3 months pre and post intervention (August 2016–February 2017). Inclusion criteria were age &gt; 18 and LMWH or UFH VTE prophylaxis. Exclusion criteria were one time or duplicate orders and VTE treatment doses. Primary endpoint was hospital services VTE use with focus on medicine service which had both interventions compared to single intervention among all other services. LMWH use increased from 51 to 57.3% (p &lt; 0.001) and UFH use decreased from 49 to 42.7% (p &lt; 0.001) for all services. For medicine service, LMWH use increased 52.5–59.6% (p &lt; 0.001) and UFH use decreased 47.5–40.4% (p &lt; 0.001). For other services, LMWH use increased 48.8–53.6% (p = 0.005) and UFH use decreased 51.2–46.4% (p = 0.005). EMR changes and prescribers’ grand rounds education resulted in 7.1% increase of LMWH use for medicine and 4.8% increase for all other services. The net increase (95% CI) in LMWH use in medicine service is 2.3% (− 1.91%, 6.56%) compared to the other services p = 0.281. Future studies are needed to reassess the effects of continued education and outcome of interventions.</description><subject>Anticoagulants</subject><subject>Cardiology</subject><subject>Electronic medical records</subject><subject>Hematology</subject><subject>Heparin</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Molecular weight</subject><subject>Prophylaxis</subject><subject>Quality control</subject><subject>Quality improvement</subject><subject>Thromboembolism</subject><subject>Thrombosis</subject><issn>0929-5305</issn><issn>1573-742X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kcuKFTEQhoMoznH0AdxIwI2b1lw7HXcyjBcYcOOAuyadVM_J0J2cSdLDOT6WT2iaHhUEIZCi6qu_kvoReknJW0qIepcpZVw3hHYNVUw1x0doR6XijRLs-2O0I5rpRnIiz9CznG8JIVoT9hSdcUJ5S6jeoZ_XxU_-hyk-BpxMgYzjiCHEozmY5AM2weE9bHE9DuCA72t9ybjsU5yHmH3GhxQP-9NkjjU2Y4GEwS12U10VYAJbUgze4phcLdu9CTeATcEGZx9uJqjqufiyrD3va_ZuMZMvJ-znKn4PM4SCc1nc6Tl6Mpopw4uH-xxdf7z8dvG5ufr66cvFh6vGcsVKI0Hyzg3GCDOyoR1aNbSu1YNQpGNCaeE6yblWetTOSie6QUln2aDBUqdFy8_Rm023zr9bIJd-9tnCNJkA9fs9q-uVXHRSVvT1P-htXFKor1spKhQVbVcpulE2xZwTjP0h-dmkU09Jvxrab4b21dB-NbQ_1p5XD8rLMIP70_HbwQqwDci1VFea_o7-v-ovRVywyQ</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Hoang, Linda</creator><creator>Islam, Shahidul</creator><creator>Hindenburg, Alexander</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20181101</creationdate><title>Utilization rates of enoxaparin and heparin in deep venous thrombosis prophylaxis after education and electronic order change at a single institution: a quality improvement study</title><author>Hoang, Linda ; Islam, Shahidul ; Hindenburg, Alexander</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-5e538dbaa4af2b6b67b6d69b470824794d8533979f9dc5d48b75dc2b9ec1d9463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Anticoagulants</topic><topic>Cardiology</topic><topic>Electronic medical records</topic><topic>Hematology</topic><topic>Heparin</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Molecular weight</topic><topic>Prophylaxis</topic><topic>Quality control</topic><topic>Quality improvement</topic><topic>Thromboembolism</topic><topic>Thrombosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hoang, Linda</creatorcontrib><creatorcontrib>Islam, Shahidul</creatorcontrib><creatorcontrib>Hindenburg, Alexander</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of thrombosis and thrombolysis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hoang, Linda</au><au>Islam, Shahidul</au><au>Hindenburg, Alexander</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utilization rates of enoxaparin and heparin in deep venous thrombosis prophylaxis after education and electronic order change at a single institution: a quality improvement study</atitle><jtitle>Journal of thrombosis and thrombolysis</jtitle><stitle>J Thromb Thrombolysis</stitle><addtitle>J Thromb Thrombolysis</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>46</volume><issue>4</issue><spage>502</spage><epage>506</epage><pages>502-506</pages><issn>0929-5305</issn><eissn>1573-742X</eissn><abstract>Despite advantages of low molecular weight heparin (LMWH), enoxaparin over heparin (UFH) for venous thromboembolism (VTE), a hospital’s prescribing trends analysis showed use of each was about equal. In an attempt to increase LMWH over UFH use, electronic medical record (EMR) changes for medical service patients and education via multidisciplinary grand rounds was provided to all services. This was a unique opportunity to study LMWH and UFH use pre and post interventions at our institution. Citrix Pharmacy data was extracted for 3 months pre and post intervention (August 2016–February 2017). Inclusion criteria were age &gt; 18 and LMWH or UFH VTE prophylaxis. Exclusion criteria were one time or duplicate orders and VTE treatment doses. Primary endpoint was hospital services VTE use with focus on medicine service which had both interventions compared to single intervention among all other services. LMWH use increased from 51 to 57.3% (p &lt; 0.001) and UFH use decreased from 49 to 42.7% (p &lt; 0.001) for all services. For medicine service, LMWH use increased 52.5–59.6% (p &lt; 0.001) and UFH use decreased 47.5–40.4% (p &lt; 0.001). For other services, LMWH use increased 48.8–53.6% (p = 0.005) and UFH use decreased 51.2–46.4% (p = 0.005). EMR changes and prescribers’ grand rounds education resulted in 7.1% increase of LMWH use for medicine and 4.8% increase for all other services. The net increase (95% CI) in LMWH use in medicine service is 2.3% (− 1.91%, 6.56%) compared to the other services p = 0.281. Future studies are needed to reassess the effects of continued education and outcome of interventions.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30136019</pmid><doi>10.1007/s11239-018-1727-x</doi><tpages>5</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0929-5305
ispartof Journal of thrombosis and thrombolysis, 2018-11, Vol.46 (4), p.502-506
issn 0929-5305
1573-742X
language eng
recordid cdi_proquest_miscellaneous_2092534855
source Springer Nature
subjects Anticoagulants
Cardiology
Electronic medical records
Hematology
Heparin
Medicine
Medicine & Public Health
Molecular weight
Prophylaxis
Quality control
Quality improvement
Thromboembolism
Thrombosis
title Utilization rates of enoxaparin and heparin in deep venous thrombosis prophylaxis after education and electronic order change at a single institution: a quality improvement study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T17%3A22%3A29IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Utilization%20rates%20of%20enoxaparin%20and%20heparin%20in%20deep%20venous%20thrombosis%20prophylaxis%20after%20education%20and%20electronic%20order%20change%20at%20a%20single%20institution:%20a%20quality%20improvement%20study&rft.jtitle=Journal%20of%20thrombosis%20and%20thrombolysis&rft.au=Hoang,%20Linda&rft.date=2018-11-01&rft.volume=46&rft.issue=4&rft.spage=502&rft.epage=506&rft.pages=502-506&rft.issn=0929-5305&rft.eissn=1573-742X&rft_id=info:doi/10.1007/s11239-018-1727-x&rft_dat=%3Cproquest_cross%3E2092534855%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c372t-5e538dbaa4af2b6b67b6d69b470824794d8533979f9dc5d48b75dc2b9ec1d9463%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2091471468&rft_id=info:pmid/30136019&rfr_iscdi=true