Disease burden and unmet needs for prevention of venous thromboembolism in medically ill patients in Europe show underutilisation of preventive therapies

Hanane Khoury; Sharon Welner; Maria Kubin; Kerstin Folkerts; Sylvia Haas

doi:10.1160/TH11-03-0168

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2011; 106(04): 600-608
DOI: 10.1160/TH11-03-0168

Review Article

Schattauer GmbH

Disease burden and unmet needs for prevention of venous thromboembolism in medically ill patients in Europe show underutilisation of preventive therapies

Authors

Hanane Khoury

¹BioMedCom Consultants inc., Montreal, Quebec, Canada
Sharon Welner

¹BioMedCom Consultants inc., Montreal, Quebec, Canada
Maria Kubin

²Bayer Schering Pharma AG, BSP-GMACS-GHEOR-GM, Wuppertal, Germany
Kerstin Folkerts

²Bayer Schering Pharma AG, BSP-GMACS-GHEOR-GM, Wuppertal, Germany
Sylvia Haas

³Institut für Experimented Onkologie und Therapieforschung, Universität München, Munich, Germany

Abstract

Summary

It was the aim of this review to assess the incidence of venous thromboembolism (VTE) and current practice patterns for VTE prophylaxis among medical patients with acute illness in Europe. A literature search was conducted on the epidemiology and prophylaxis practices of VTE prevention among adult patients treated in-hospital for major medical conditions. A total of 21 studies with European information published between 1999 and April 2010 were retrieved. Among patients hospitalised for an acute medical illness, the incidence of VTE varied between 3.65% (symptomatic only over 10.9 days) and 14.9% (asymptomatic and symptomatic over 14 days). While clinical guidelines recommend pharmacologic VTE prophylaxis for patients admitted to hospital with an acute medical illness who are bedridden, clear identification of specific risk groups who would benefit from VTE prophylaxis is lacking. In the majority of studies retrieved, prophylaxis was under-used among medical inpatients; 21% to 62% of all patients admitted to the hospital for acute medical illnesses did not receive VTE prophylaxis. Furthermore, among patients who did receive prophylaxis, a considerable proportion received medication that was not in accord with guidelines due to short duration, suboptimal dose, or inappropriate type of prophylaxis. In most cases, the duration of VTE prophylaxis did not exceed hospital stay, the mean duration of which varied between 5 and 11 days. In conclusion, despite demonstrated efficacy and established guidelines supporting VTE prophylaxis, utilisation rates and treatment duration remain suboptimal, leaving medical patients at continued risk for VTE. Improved guideline adherence and effective care delivery among the medically ill are stressed.

Keywords

Venous thromboembolism - thromboprophylaxis - hospitalised medically ill patients - burden - clinical practice

Full Text

References

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