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document
Effectiveness of written guidelines on the appropriateness of thromboprophylaxis prescriptions for medical patients : a prospective randomized study . OBJECTIVE To assess the effectiveness of providing doctors with written thromboprophylaxis prescription aids based on current recommendations . DESIGN A prospective trial of specific anticoagulant prescription forms : a 1-day survey before and after the intervention in each centre . SETTING 30 Internal Medicine departments of Assistance Publique-Hôpitaux de Paris . SUBJECTS All inpatients were included , except those who were either admitted or discharged on the day of the survey , and those receiving curative anticoagulant treatment . INTERVENTIONS The study included three parts : ( i ) a 1-day baseline survey ; ( ii ) over the following 3-month period , departments were randomized into two groups : all practitioners in wards allocated to the intervention group were required to systematically use specific anticoagulant prescription forms , whilst doctors in the control group continued prescribing according to their usual practices and ( iii ) a 1-day postintervention survey . MAIN OUTCOME MEASURE The proportion of prescriptions in accordance with the recommendations . RESULTS 1,469 patients were included . The intervention produced a significant reduction in the frequency of over-prescriptions , from 25 % to 14 % of the patients who did not meet the guideline criteria ( adjusted OR : 0.3 ; 95 % CI : 0.1-0.8 ) . Using specific forms did not improve under-prescription of anticoagulants . A little over 60 % of the patients who met guideline criteria for thromboprophylaxis were prescribed anticoagulants in both intervention and control wards , either at baseline or after intervention . CONCLUSIONS Multitargeted interventions using a variety of means and strategies should still be considered to improve prescriptions that may have a significant impact on health expenses and , most importantly , on patients outcomes .
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Intervention_Pharmacological
thromboprophylaxis prescriptions
28010
Intervention_Pharmacological
thromboprophylaxis prescription aids
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Outcome_Other
Effectiveness
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Outcome_Other
effectiveness
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Participant_Condition
thromboprophylaxis prescriptions for medical patients :