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The Impact of an Antithrombotic Stewardship Program on Heparin-Induced Thrombocytopenia Management.
- Source :
- Journal of Pharmacy Practice; Dec2023, Vol. 36 Issue 6, p1343-1349, 7p
- Publication Year :
- 2023
-
Abstract
- Background: An antithrombotic stewardship program was implemented to reduce IV DTI use and increase fondaparinux and direct oral anticoagulant (DOAC) use for suspected or confirmed Heparin-induced thrombocytopenia (HIT). Objectives: This study evaluated the impact of an antithrombotic stewardship program on IV DTI utilization in patients with HIT. Methods: A retrospective analysis of adults receiving IV DTIs or fondaparinux from July 2016 to July 2017 (pre-stewardship) and October 2017 to July 2019 (post-stewardship) was conducted. Results: The median duration of IV DTI administration was not significantly different in HIT-negative patients between the pre- and post-stewardship cohorts (1.6 days (25th percentile (p25), 75th percentile (p75):.5, 3.3) vs 1.7 days (p25, p75:.9, 3.9), P =.31). The median duration of IV DTI administration in HIT-positive patients was 9.9 days (p25, p75: 7.6, 21.0) pre-stewardship and 7.3 days (p25, p75: 4.8, 16.5) post-stewardship (P =.18). For HIT-positive patients, the time from HIT diagnosis to discharge was 12.8 days (p25, p75: 8.9, 24.9) and 9.2 days (p25, p75: 4.0, 18.1) in the pre- and post-stewardship cohorts, respectively (P =.07). Fondaparinux and DOAC prescribing rates were 40.7% and 62.2% in the pre- and post-stewardship cohorts, respectively (P =.09). The percentage of patients with no contraindications to IV DTI alternatives receiving these agents increased from 31.2% to 78.6% (P =.01) following stewardship implementation. Conclusions: Intravenous DTI alternative utilization increased significantly after stewardship implementation. Stewardship implementation was associated with a non-statistically significant trend towards decreased IV DTI utilization and decreased length of stay for HIT-positive patients. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 08971900
- Volume :
- 36
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Journal of Pharmacy Practice
- Publication Type :
- Academic Journal
- Accession number :
- 173468003
- Full Text :
- https://doi.org/10.1177/08971900221116185