Electronic Alerts to Prevent Venous Thromboembolism among Hospitalized Patients

• Published in: The New England journal of medicine Vol. 352; no. 10; pp. 969 - 977
• Main Authors: Kucher, Nils, Koo, Sophia, Quiroz, Rene, Cooper, Joshua M, Paterno, Marilyn D, Soukonnikov, Boris, Goldhaber, Samuel Z
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 10-03-2005
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Anticoagulants - therapeutic use; Bandages - utilization; Biological and medical sciences; Blood and lymphatic vessels; Blood clots; Cardiology. Vascular system; Computer programming; Decision Support Systems, Clinical; Disease-Free Survival; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Follow-Up Studies; General aspects; Health risk assessment; Hospital Information Systems; Humans; Male; Medical Records Systems, Computerized; Medical sciences; Middle Aged; Prevention; Pulmonary Embolism - prevention & control; Quality Assurance, Health Care; Reminder Systems; Risk Assessment - methods; Risk Factors; Software; Thromboembolism - prevention & control; Venous Thrombosis - prevention & control; Vascular disease; Human; Medicine; Prevention; Electronics; Cardiovascular disease; Hospitalization; Thromboembolism; Vein; Thrombosis; Embolism
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa041533

Hospitalized patients may be at risk for venous thromboembolism as a result of bed rest, cancer, or major surgery, yet not all such patients receive prophylaxis against deep-vein thrombosis. An electronic alert system, which prompted physicians to prescribe prophylaxis to patients at risk for deep-vein thrombosis, was determined not only to increase the use of prophylactic measures but also to reduce the risk of venous thromboembolism.
An electronic alert system, which prompted physicians to prescribe prophylaxis to patients at risk for deep-vein thrombosis, was determined to increase the use of prophylactic measures and reduce the risk of venous thromboembolism.
Despite the existence of detailed European
1
and North American
2
consensus guidelines, the use of prophylaxis against venous thromboembolism continues to be spotty. Randomized, controlled trials of hospitalized medical patients
3
–
5
have shown that certain measures safely prevent venous thromboembolism, yet European
6
,
7
and North American
8
–
10
surveys show persistent underuse of prophylaxis. In a registry of 5451 consecutive patients with ultrasonographically confirmed deep-vein thrombosis at 183 U.S. institutions,
10
only 42 percent of inpatients had received prophylaxis within 30 days before deep-vein thrombosis developed. Although approaches involving continuing medical education
11
and computerized electronic alerts
12
,
13
can increase physicians' use of prophylaxis . . .