Kiracı Zeynep Karaburç, Yalçın Nadir, Cennet Ömer, Demirkan Kutay, Yorgancı Kaya
Department of Clinical Pharmacy, Faculty of Pharmacy, Hacettepe University, Ankara, 06230, Türkiye.
Department of General Surgery, Faculty of Medicine, Hacettepe University, Ankara, 06230, Türkiye.
Thromb J. 2023 Aug 9;21(1):86. doi: 10.1186/s12959-023-00530-2.
Despite the risks of venous thromboembolism (VTE) in surgical patients are well defined, primary thromboprophylaxis (TP) can be neglected. The aim of this study was to evaluate the risk of VTE and appropriateness of TP and to assess the effects of education and clinical pharmacy (CP) services.
This study was conducted in a total of 3 periods (n = 800): pre-education (n = 340), post-education (n = 269) and CP intervention period (n = 191) and the risk of VTE and the appropriateness of TP were evaluated. At the end of pre-education period, patients were re-evaluated after education was given about the guidelines on TP and an educative poster was posted in the services (post-education period). During the CP intervention period, the CP made recommendations in terms of optimal TP use to the physicians in charge.
While there was no significant difference in the optimal TP rate administered to the patients before and after education (138/340, 40.6% vs. 122/269, 45.4%; p = 0.238); this rate was increased to 113/191 (59.2%) in the CP intervention period (p = 0.004). High-risk patients who received one type of TP constituted the majority of patients who did not receive optimal TP. While the ratio of high-risk patients undergoing a single type of TP in the pre- and post-education periods (104/340, 30.6% vs. 83/269, 30.9%), was similar (p = 0.819); with the CP interventions, this rate was reduced to 35/191 (18.3%) (p = 0.001).
Even though education has positive influence on surgeons, the implementation of CP practices is more effective especially in terms of maintaining optimal TP.
尽管手术患者发生静脉血栓栓塞症（VTE）的风险已明确，但一级血栓预防（TP）仍可能被忽视。本研究旨在评估VTE风险及TP的适宜性，并评估教育和临床药学（CP）服务的效果。
本研究共分3个阶段（n = 800）：教育前（n = 340）、教育后（n = 269）和CP干预期（n = 191），评估VTE风险及TP的适宜性。在教育前期结束时，在就TP指南进行教育并在服务处张贴教育海报后（教育后期）对患者进行重新评估。在CP干预期，CP就最佳TP使用向主管医生提出建议。
教育前后给予患者的最佳TP率无显著差异（138/340，40.6%对122/269，45.4%；p = 0.238）；但在CP干预期该率增至113/191（59.2%）（p = 0.004）。接受单一类型TP的高危患者占未接受最佳TP患者的大多数。教育前和教育后期接受单一类型TP的高危患者比例相似（104/340，30.6%对83/269，30.9%）（p = 0.819）；通过CP干预，该率降至35/191（18.3%）（p = 0.001）。
尽管教育对外科医生有积极影响，但CP措施的实施更有效，尤其是在维持最佳TP方面。
