Author: Anna D. Garrett, PharmD, BCPS, CPP
A recent study
of nonsurgical patients
suggests that
extending venous
thromboembolism
(VTE) prophylaxis
for 1 month postdischarge
can lower
VTE risk by 44%. The study, which
was conducted in Europe and North
America, randomized acutely ill
patients who were immobilized in the
hospital to either stop VTE prophylaxis
at discharge or continue it at home for
1 month. This is the first study to look
at extending prophylaxis beyond 7 to
10 days post-discharge in medical
patients. The reduction in VTE events
extended out to 90 days. Bleeding
events were higher in the extendedprophylaxis
group, but the authors concluded
that bleeding events were in
line with expectations and did not
appear clinically significant.
The results of this study are important
because sicker patients are being
discharged from the hospital. Their risk
of VTE after discharge may increase
because there may be less encouragement
given to the patient by caregivers
to maintain mobility. Extended VTE prophylaxis
appears to lessen this risk.