The study, which examined data from more than 20,000 patients on the medical wards at 35 Michigan hospitals, found that greater rates of drug-related preventative measures were not associated with a reduced rate of blood clots (known as venous thromboembolism) among hospitalized patients.
The new findings appear in JAMA Internal Medicine.
“Numerous quality improvement efforts have focused on increasing the use of preventative medications to reduce blood clots and subsequent complications among hospitalized patients but we did not find evidence that these efforts actually reduce risks,” says lead author Scott Flanders, M.D., M.H.M, professor of internal medicine and director of hospital medicine at the U-M Medical School.
“Our findings imply that efforts to broadly increase rates of drug interventions in non-ICU medical patients may not result in meaningful outcomes.”
The participating hospitals are part of a quality collaborative sponsored by Blue Cross Blue Shield of Michigan and the Blue Care Network.
Other study highlights:
• The rate of venous thromboembolism (VTE) after 90 days of follow-up was low (1.1%)
• The rate of VTE diagnosed in the hospital was even lower at 0.16%. The majority of hospital-associated VTEs observed in the study were diagnosed after discharge from the hospital.
• Hospitals delivering higher rates of pharmacologic VTE prophylaxis did not have lower risk adjusted rates of VTE compared to hospitals using pharmacologic prophylaxis less often
• Strategies designed to broadly increase use of pharmacologic prophylaxis for all medical patient are unlikely to demonstrate reduced rates of VTE. A more targeted approach is needed.
• Of patients who did develop a VTE within 90 days of hospital admission, over 70% had received pharmacologic prophylaxis, arguing that we need better approaches to preventing hospital-associated VTE in high risk patients.