Australian scholar delivers improvements in anticoagulant use
Many lives and several million dollars could be saved every year by improving the use of anticoagulant medications according to a National Health and Medical Research Council NICS PhD scholar, Dr Luke Bereznicki.
Dr Bereznicki, a lecturer in pharmacy at the University of Tasmania, says the under, over or misuse of anticoagulant medications in Australia has continued to rise over the past 25 years, resulting in avoidable complications and hospital deaths.
He said that 10% of all deaths in hospitalised patients are due to preventable blood clots or venous thromboembolism (VTE), yet anticoagulants are not always routinely prescribed.
Similarly, up to 10% of people commencing warfarin therapy develop life threatening complications, such as major bleeding, within three months of hospital discharge. Self-monitoring of warfarin therapy has emerged as the optimal method to manage patients on blood thinning medications in the community, but it is not widely practised in Australia.
Dr Bereznicki developed a series of implementation projects as part of his PhD studies to address these important evidence-practice gaps in selected Tasmanian public hospitals. The role of pharmacists within these projects was to provide education, support and training to both patients and medical staff to improve anticoagulant use.
These projects resulted in dramatic changes in practice in the participating hospitals. In one study, the appropriate use of agents to prevent VTE increased from only 10% to more than 70% in hospitalised, elderly medical patients. In a second study, the rate of complications such as major bleeding and stroke occurring within three months of hospital discharge was reduced from 11% to just 2%. This was a result of better use of hospital guidelines for warfarin therapy together with the provision of more detailed information to general practitioners.
