Evaluation of an intervention on the prescription and biological surveillance of low-molecular weight heparins in medicine
Fiessinger, J.N.; Chatellier, G.
Presse Medicale 25(36): 1777-1780
1996
ISSN/ISBN: 0755-4982 PMID: 8991025 Document Number: 457659
We evaluated the effect of oral recommendations documents distributed to prescribing physicians on the use of low-molecular weight heparin (LMWH) and laboratory test orders. Prescription of LMWH over a 6 month period was left to the total discretion of the prescribing physician (observation period). An information session and recommendation documents were then proposed describing prophylactic use of LMWH and appropriate hemostasis monitoring tests for curative treatments. Prescriptions and laboratory test orders were then recorded for the next six months (intervention period). Diffusion of recommendation documents to prescribers led to a 50% decrease in the prescription of low-molecular weight heparin for prophylaxis and a significant drop in orders for anti-Xa and prothrombin. These results confirm the efficacity of informing prescribing physicians on the use of low-molecular weight heparins and underlines the need to validate methods used for the prevention of venous thrombosis.