Adherence to Venous Thromboembolism Prophylaxis Guidelines in Hospitalized Elders
住院老年人遵守静脉血栓栓塞预防指南
基本信息
- 批准号:8754858
- 负责人:
- 金额:$ 11.78万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2014
- 资助国家:美国
- 起止时间:2014-09-01 至 2016-05-31
- 项目状态:已结题
- 来源:
- 关键词:AddressAdherenceAdoptedAmericanAnticoagulant therapyAnticoagulantsAnticoagulationAreaBed restBedsCaringChestChronicClinicalDataDemographic FactorsDoseElderlyElectronicsEvaluationFaceFoundationsFutureGeriatricsGoalsGuidelinesHealth systemHematologyHemorrhageHeparinHigh PrevalenceHospitalizationHospitalsInjectableInpatientsIntervention StudiesLength of StayLow PrevalenceLow-Molecular-Weight HeparinManualsMeasuresMedicalMedical RecordsMedicineObservational StudyPatientsPharmaceutical PreparationsPhysical activityPhysiciansPopulationPrevention therapyPrincipal InvestigatorProphylactic treatmentProviderPublic HealthRecording of previous eventsRecordsResearchRiskRisk AssessmentSafetySamplingServicesStratificationThromboembolismThrombosisUniversitiesUniversity HospitalsVenousWalkingWorkabstractingagedbasecareercollegecostcost effectivedata portaldesignfield studyfondaparinuxhigh riskimprovedindexinginsightolder patientpatient safetypreventprogramsprospectivepublic health relevance
项目摘要
DESCRIPTION (provided by applicant): There are important public health concerns related to inappropriate use of venous thromboembolism (VTE) prophylaxis among medically ill hospitalized elderly patients with low risk of VTE occurrence. Specifically, use of anticoagulants (heparin products) for VTE prophylaxis when not medically indicated may be harmful, and is a major patient safety issue that also has a significant cost effect on health systems. To this end, the American College of Chest Physician (ACCP) 9th Edition guidelines explicitly recommend a risk-stratification approach, rather than universal use of anticoagulants for VTE prophylaxis. Even though many medical inpatients are at high risk for VTE, there are others whom do not have sufficient risk to warrant prophylaxis, and use in this population is inappropriate. The first
aim of this application proposes to determine the magnitude and scope of inappropriate use of anticoagulant VTE prophylaxis in low risk older adults. This aim will be achieved by using data abstraction from the Duke University Health System electronic records to determine (1) the prevalence of low risk elders using criteria proposed by ACCP guidelines, and (2) anticoagulant VTE prophylaxis use in this group. Guideline directed use of pharmacologic VTE prophylaxis also emphasizes mobility evaluation. Mobility is a key component of risk stratification. Poor mobility evaluation by providers may be a significant barrier to appropriate use of VTE prophylaxis. Our second aim proposes to determine whether level of mobility during hospitalization is being used to influence use and duration of VTE prophylaxis among medically ill hospitalized elders. To achieve this aim, we will collect prospective observational data to objectively measure inpatient mobility using patient mounted accelerometers during patient hospital stays. Our goal is to improve the appropriateness of use of VTE prophylaxis among those in which the risks of harm may outweigh the benefit. Results from our study will provide important insights about use of risk assessment, and the relationship between patient mobility and VTE prophylaxis. These results are critical to understanding how to take the next steps toward improving the appropriate use and safety of anticoagulants in hospitalized older adults. Information from this study could be used in future proposals to study interventions to ultimately improve hospital practice in the care of older adults. Our investigative team at Duke is unique since we have expertise in all key fields of study: geriatrics, hospital medicine, hematology, and physical activity, that also have a longstanding history of working well with each other. As such, this collaborative team and research plan is designed to provide the principal investigator with a foundation from which to pursue an independent career in geriatric and hospital medicine research.
描述(由申请人提供):在住院的低风险静脉血栓形成的老年患者中,与静脉血栓栓塞症(VTE)预防措施的不当使用有关的重要公共卫生问题。具体地说,在没有医学指征的情况下使用抗凝剂(肝素产品)预防VTE可能是有害的,是一个重大的患者安全问题,也对卫生系统有显著的成本影响。为此,美国胸科医师学会(ACCP)第9版指南明确建议采用风险分层方法,而不是在预防VTE时普遍使用抗凝剂。尽管许多内科住院患者患VTE的风险很高,但也有其他人没有足够的风险来保证预防,因此在这一人群中使用是不合适的。第一
该应用的目的是确定在低危老年人中不适当使用抗凝剂VTE预防的程度和范围。这一目标将通过使用从杜克大学卫生系统电子记录中提取的数据来确定(1)使用ACCP指南建议的标准来确定低风险老年人的患病率,以及(2)在这一组中使用抗凝剂VTE预防。指导使用药物性VTE预防的指南也强调灵活性评估。流动性是风险分层的关键组成部分。提供者的移动性评估不佳可能是适当使用VTE预防措施的一个重大障碍。我们的第二个目标是确定住院期间的流动性水平是否被用来影响内科疾病住院老年人的VTE预防措施的使用和持续时间。为了实现这一目标,我们将收集前瞻性的观察数据,以客观地测量住院患者在住院期间使用患者安装的加速计的流动性。我们的目标是在危害可能大于收益的情况下,改进VTE预防措施的适当性。我们的研究结果将为风险评估的使用以及患者机动性和VTE预防之间的关系提供重要的见解。这些结果对于理解如何采取下一步措施来改善住院老年人抗凝剂的适当使用和安全性至关重要。这项研究的信息可以用于未来的建议,以研究干预措施,最终改善医院对老年人的护理实践。我们在杜克大学的调查团队是独一无二的,因为我们在所有关键研究领域都有专业知识:老年病学、医院医学、血液学和体力活动,这些领域也有着长期合作的历史。因此,这个协作团队和研究计划旨在为首席研究人员提供一个基础,以便在老年和医院医学研究领域寻求独立的职业生涯。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
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JULIESSA M PAVON其他文献
JULIESSA M PAVON的其他文献
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{{ truncateString('JULIESSA M PAVON', 18)}}的其他基金
Deprescribing Central Nervous System Medications in Hospitalized Older Adults
停用住院老年人的中枢神经系统药物
- 批准号:
10550128 - 财政年份:2019
- 资助金额:
$ 11.78万 - 项目类别:
Deprescribing Central Nervous System Medications in Hospitalized Older Adults
停用住院老年人的中枢神经系统药物
- 批准号:
10092882 - 财政年份:2019
- 资助金额:
$ 11.78万 - 项目类别:
Deprescribing Central Nervous System Medications in Hospitalized Older Adults
停用住院老年人的中枢神经系统药物
- 批准号:
9920641 - 财政年份:2019
- 资助金额:
$ 11.78万 - 项目类别:
Deprescribing Central Nervous System Medications in Hospitalized Older Adults
停用住院老年人的中枢神经系统药物
- 批准号:
10361399 - 财政年份:2019
- 资助金额:
$ 11.78万 - 项目类别:
Adherence to Venous Thromboembolism Prophylaxis Guidelines in Hospitalized Elders
住院老年人遵守静脉血栓栓塞预防指南
- 批准号:
8919212 - 财政年份:2014
- 资助金额:
$ 11.78万 - 项目类别:
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