Forms of VTE including pulmonary embolism are the leading cause of preventable death in hospitals.
According to the Centers for Disease Control and Prevention (CDC), as many as 900,000 people could be affected by VTE each year in the US. Of these, an estimated 60,000-100,000 Americans will die from the condition.
Fortunately, VTE can be treated with an approach known as VTE prophylaxis - a form of treatment known to reduce mortality by up to 80%. This treatment can involve drugs such as heparin and warfarin and non-pharmacological measures such as compression stockings.
However, the new study, published in the Canadian Journal of Cardiology, suggests that this treatment is not offered universally to patients at a high risk of developing blood clots.
"There is a high rate of noncompliance with accepted guidelines for the prevention of VTE," state the study authors. "The introduction of a guideline-based protocol significantly increased compliance. However, a substantial proportion of patients at high risk from VTE, still did not receive prophylaxis."
Compliance only improved slightly after an educational program
The researchers assessed how frequently VTE prophylaxis was offered to patients deemed to be at risk for VTE at a university-affiliated, tertiary care cardiology center. They audited the charts of patients 3 and 5 months prior to the initiating of an educational program at the facility, and then conducted chart reviews again 3 and 5 months later.
- Some people may develop DVT without any symptoms, although most cases will involve pain and swelling
- DVT can be caused by a wide range of factors, including inactivity, pregnancy and cancer
- In most cases of DVT, only one leg is affected.
Introducing a guideline-based protocol for VTE prophylaxis was the focus of the program.
For the first set of audits, a total of 173 patients were identified who were considered to be at high risk for VTE. For the second set, the charts of 247 high-risk patients were reviewed.
Around 36% patients identified at the facility as being at risk for VTE did not receive VTE prophylaxis prior to the initiation of the educational program. To the surprise of the researchers, however, they found that 21% of appropriate patients were still not receiving the treatment 3 months after the program.
Five months after the program, the rate of noncompliance had risen to 28%.
Lead investigator Colette Seifer, an associate professor in the Department of Internal Medicine at the University of Manitoba in Canada, explains why improving the provision of VTE prophylaxis can be difficult:
"Awareness and education surrounding VTE prophylaxis is challenging in the inpatient teaching unit model due to a number of factors, including the high turnover of senior and junior physicians as well as nursing staff. A single time point intervention is unlikely to result in a sustained improvement in VTE prophylaxis rates."
The researchers suggest that compliance rates potentially could be improved by introducing electronic patient records, new software programs and automated alerts to flag up patients that could benefit from the treatment.
Recently, Medical News Today reported on a study that described how a new type of artificial blood vessel coating could resist blood clot formation.
The coating consists of a thin film of aluminum oxide blended with a substance called urokinase-type plasminogen activator that activates a clot-busting enzyme. The study authors believe their findings could help improve any kind of implant, including artificial ureters.