Journal Article Observational Study Ppublish 1 citation
PubMed: 39776375 DOI: 10.1007/s11096-024-01857-0
A clinical decision support tool for improving venous thromboembolism risk assessment and thromboprophylaxis prescribing compliance within an electronic medication management system: a retrospective observational study.
Int J Clin Pharm 47(3):699-707
Authors: Samantha Loh, Kimberly Wijaya, Michelle Rogers, Mohammad Asghari-Jafarabadi, Robert Wojnar
Affiliations
- Pharmacy Department, Cabrini Health, 183 Wattletree Road Malvern, Malvern, VIC, 3144, Australia.
- Pharmacy Department, Cabrini Health, 183 Wattletree Road Malvern, Malvern, VIC, 3144, Australia.
- Cabrini Research, Cabrini Health, Malvern, VIC, Australia.
- School of Public Health and Preventive Medicine, Monash University, VIC, Australia.
Abstract
BACKGROUND
Despite various interventions to improve best-practice venous thromboembolism (VTE) prevention measures within hospitals, compliance remains poor. For health services utilising electronic medication management systems (eMMS), implementation of clinical decision support (CDS) tools could address this gap.
AIM
To evaluate whether local implementation of an integrated electronic alert system linked with a computerised physician order entry (CPOE)-based order set for VTE risk assessment within an eMMS improves the rates of timely VTE risk assessment and guideline-compliant VTE prophylaxis prescribing among hospitalised patients.
METHOD
A retrospective observational study conducted among hospitalised patients pre- and post-implementation of an electronic alert system combined with a CPOE-based order set to prompt VTE risk assessment documentation and VTE prophylaxis prescribing within a single tertiary hospital. Admissions were consecutively screened over 7-day periods before and after implementation for inclusion and assessed for compliance with a local VTE prevention protocol.
RESULTS
Eight hundred and fifty patients (458 pre-intervention, 392 post-intervention) were included for evaluation. Rates of VTE risk assessment documentation within 24 h of admission increased by 29.9% (p < 0.001). Guideline-compliant VTE prophylaxis improved by 10.4% (p < 0.001). Patients with completed VTE risk assessments were significantly more likely to receive guideline-compliant VTE prophylaxis, compared to patients without documented VTE risk assessments (19.3% difference, p < 0.001). After adjusting for demographic differences, the odds of achieving positive outcomes significantly increased across all measures, with adjusted odds ratios ranging from 1.95 to 4.89 (p < 0.001).
CONCLUSION
Local implementation of CDS featuring CPOE within the eMMS improved rates of VTE risk assessment documentation and guideline-compliant VTE prophylaxis prescribing.
MeSH
Thromboembolism, Risk Assessment, Documentation, Drug Therapy, Venous Thromboembolism