Assessing the uptake of national initiatives to improve venous thromboembolism patient care in the UK
Abstract number: OC-TH-076
Arya1 R., McManus2 A., Paneesha3 S., Scriven4 N., Nokes5 T., Farren6 T., Nieland7 A., Rose8 P., Bacon9 S., O’Shaughnessy10 D.
11Haematology, King's College Hospital 1010Blood Policy Unit, Department of Health, London, UK 22Director, MMRx Consulting, London 33Haematology, Heart of England NHS Foundation Trust, Birmingham 44MAU, The Calderdale Royal Hospital, Halifax 55Haematology, Derriford Hospital, Plymouth 66Haematology, Barts and the London Hospitals, London 77Haematology, Northampton General Hospital NHS Trust, Northampton 88Haematology, Warwick Hospital, Warwick 99DVT Service, Scarborough General Hospital, Scarborough
How-to-cite Arya R, McManus A, Paneesha S, Scriven N, Nokes T, Farren T, Nieland A, Rose P, Bacon S, O’Shaughnessy D. Assessing the uptake of national initiatives to improve venous thromboembolism patient care in the UK. Journal of Thrombosis and Haemostasis 2009; Volume 7, Supplement 2: Abstract OC-TH-076
Publication of national VTE prevention guidelines, a national risk assessment tool and a VTE prevention pathway within ‘Map of Medicine’ and creation of a national VTE Exemplar Centre network provide UK hospitals with a framework for assessing and implementing VTE prevention, fulfilling Government commitments to reduce VTE deaths. We assessed current VTE practice by surveying the VERITY registry and Exemplar Centre networks.
A 23-question survey developed by the VERITY Steering Committee was distributed in December 2008 to 52 UK hospitals: 47 VERITY centres (9 also enrolled in the PUSH VTE outcomes initiative) and 7 Exemplar Centres (2 also VERITY centres). It included questions on diagnosis, prevention and treatment.
Of 33 responding centres, 32 used ≥ 1 VTE risk-assessment tool: national (12%), surgical-specific (55%) and/or medical-specific (64%) or unified (21%). 47% of centres had audited use of risk assessment: 67% of Exemplar, 22% of PUSH and 44% of VERITY centres. Among the 9 centres reporting rates, the percentage of patients risk assessed ranged from to 22% to 92–95% in 4 Exemplar centres and 10% to 74% in 4 VERITY centres and was < 3% in 1 PUSH centre. All centres used prophylaxis guidelines. More centres (71%) had audited prophylaxis use than risk assessment: all Exemplar centres, 50% of PUSH centres and 63% of VERITY centres. Appropriate prophylaxis rates were 45–90%, 37–50% and 10–83% in Exemplar, PUSH and VERITY centres.
VTE risk assessment and thromboprophylaxis rates are the main performance measures for the VTE prevention process. Our data demonstrate that prophylaxis and risk assessment rates vary widely across the UK. Prophylaxis practice is more advanced than risk assessment, and work is needed to ensure universal risk assessment of all hospitalised patients.
Disclosure of interest: Aidan McManus, MMRx Consulting, Owner.
MMRx Consulting has received payments from several pharmaceutical companies with products in the anti-thrombosis market.
All others, None declared.