NP-008 Monitoring of prescriptions on prophylaxis of venous thromboembolism (VTE) in medical patients in Beatriz Ângelo Hospital

Background and importance VTE is an important public health problem because of its impact in terms of morbidity, mortality, and associated costs. VTE prevention is a priority strategy to improve patient safety. More than half of all hospitalised patients are at risk for VTE. Previous studies have reported overall VTE prophylaxis rates ranging from 13% to 64%. Aim and objective To assess the risk of VTE in patients hospitalised for medical pathology, using clinical records using the Padua score. Classify patients according to prescription, risk factors (RF) and contraindication (CI). To verify the use of a VTE risk assessment model. Create a computer application with the Padua score and integrate it into the prescription program. Materials and methods Descriptive observational study during September in the medical patients admitted with age ≥18 years. Patients were classified according to the Padua score, LMWH prescription and contraindications in 5 populations: (a) with prescription and without RF or CI, (b) without prescription and with RF (c) with an unadjusted dose (d) with prescription and with RF, (e) without prescription and without RF or CI. Pharmaceutical intervention was performed in patients classified in (a), (b) and (c), pharmaceutical intervention, medical justification and information on the use of a VTE evaluation model were recorded. Results Of the total number of patients (218), 66.5% had a risk of VTE of these 58.7% had no CI for pharmacological prophylaxis. Of the 58.7%, 42% do not have prescription of prophylaxis or have dose misfit. Of the population without risk of VTE 35.6% have a prescription of prophylaxis. Of the population at risk of VTE and cancer, 39% do not have prophylaxis whereas in the population at risk of VTE and without cancer, 18% have no prescription. A pharmaceutical intervention was performed in 81% of the prescriptions with an acceptance rate of 29%. Conclusion and relevance According to the results, 42% of the patients do not have prophylactic prescription or have an unadjusted dose. In patients with score ≥4 and without CI, the prophylaxis percentage is lower in cancer patients. The vast majority of physicians still do not use a VTE risk assessment model. The application with Padua score was presented to physicians.