Improved utilisation of venous thromboembolism prophylaxis in renal-impaired patients following a clinical pharmacist intervention.

OBJECTIVES: To evaluate the role of the clinical pharmacist in improving venous thromboembolism (VTE) prophylaxis prescription in patients with renal impairment (RI).
METHODS: This was an interventional cross-sectional study conducted in a nephrology ward. Patients' risk scores for VTE and bleeding during hospitalisation (evaluated by the Caprini Risk Assessment Model (RAM), Padua Prediction Score and IMPROVE Bleeding Risk Score, respectively), and the rate of VTE prophylaxis administration to patients, were evaluated before and after a clinical pharmacist's intervention.
RESULTS: In the pre-intervention phase, 34.8% of high-VTE-risk patients, of whom 12.5% were also at high risk of bleeding, received pharmacological prophylaxis. Moreover, 22.2% of low-VTE-risk patients received prophylaxis. In the intervention phase, prophylaxis was administered to all high-risk patients (mechanical prophylaxis in 7% of patients with a high risk of both VTE and bleeding, and heparin in the remainder) and to 3.3% of those at low risk of VTE.
CONCLUSIONS: The clinical pharmacist's intervention using RAMs can improve the rate of thrombosis prophylaxis prescription in patients with RI who have a high risk of VTE. © European Association of Hospital Pharmacists 2022. No commercial re-use. See rights and permissions. Published by BMJ.