Implementation of Outpatient Treatment of Deep-vein Thrombosis in Private Practices in Germany

• Published in: European journal of vascular and endovascular surgery 2005-09, Vol.30 (3), p.319-324
• Main Authors: Blättler, W., Gerlach, H.E.
• Format: Article
• Language: English
• Subjects: Ambulatory Care; Anticoagulants - therapeutic use; Bandages; Deep-vein thrombosis; Early Ambulation; Germany; Humans; Implementation; Outpatient treatment; Practice Patterns, Physicians; Private Practice; Sponsoring; Treatment Outcome; Venous Thrombosis - economics; Venous Thrombosis - therapy
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2005.05.001

Implementation of outpatient treatment (OT) of deep-vein thrombosis (DVT) is slow despite clear evidence that it is effective, safe and cost-efficient. An initiative was launched with the help of the Professional Association of Phlebologists of Germany and the industry to familiarize physicians in private practice who had no prior experience with OT of DVT. Data on quality of treatment with the low-molecular-weight heparin tinzaparin and phenprocoumon, compliance, clinical outcome, venous ultrasound, patients' satisfaction and quality of life were collected in a registry, which was open from July 1999 to December 2000. The results were published and their impact on further management of patients was assessed in second survey reported here. Patients of both series were followed-up clinically and with ultrasound over the 1st month of treatment. Of 67 physicians entering 827 patients into the registry 26 answered a questionnaire on how they treated further patients. Their case load had increased by 450% and data were provided on 540 consecutive patients managed between January and June 2002. OT increased overall from 76 to 92%, that of popliteo-femoral DVT from 71 to 92%, and that of pelvic DVT from 38 to 65%. Medical reasons to decide against OT decreased from 89 to 56% (p