@article{21a5a2c8d4a04e3597074cfaded988a6,
title = "Exploring the impact of route of administration on medication acceptance in hospitalized patients: Implications for venous thromboembolism prevention",
abstract = "Background Non-administration of venous thromboembolism (VTE) prophylaxis contributes to preventable patient harm. We hypothesized that non-administration would be more common for parenteral VTE prophylaxis than oral infectious disease or cardiac prophylaxis or for treatment medications. The primary study goal was to determine if non-administration of parenteral VTE prophylaxis is more frequent than other prophylactic or treatment medications. Methods In this retrospective cohort study of consecutive admissions we used descriptive statistics and risk ratios (RR) to compare the number of non-administered doses of VTE prophylaxis, oral infectious disease and cardiovascular prophylaxis and treatment medications. To quantify the influence of demographic and clinical characteristics on non-administration, we estimated incidence rate ratios from Poisson regression models. Results 645 patients were admitted from July 1, 2014 through March 31, 2015. Median age was 52 years (Interquartile range 43–57) and 365 (56.6%) were male. Subcutaneous VTE prophylaxis doses were not administered nearly 4-fold more frequently than oral infectious disease and cardiovascular prophylaxis (RR = 3.93; 95% CI 3.36–4.59) and 3-fold more frequently than treatment medications (RR = 3.06; 95% CI 2.91–3.22). Ninety percent of non-administered doses of VTE prophylaxis were refused. Risk factors for non-administration included younger age (age 18–35 years), male sex, uninsured status, HIV-positivity and high VTE risk status. Conclusions Subcutaneous VTE prophylaxis is not administered more frequently than oral infectious diseases or cardiac prophylaxis and treatment medications. These data suggest that availability of an oral medication could improve the effectiveness of VTE prophylaxis in real world settings.",
keywords = "Medication adherence, Patient safety, Prophylaxis, Venous thromboembolism",
author = "Popoola, {Victor O.} and Farrah Tavakoli and Lau, {Brandyn D.} and Matthew Lankiewicz and Patricia Ross and Peggy Kraus and Dauryne Shaffer and Hobson, {Deborah B.} and Aboagye, {Jonathan K.} and Farrow, {Norma A.} and Haut, {Elliott R.} and Streiff, {Michael B.}",
note = "Funding Information: Conflicts of interest and funding disclosure for all authors: Mr. Lau, Drs. Haut, Aboagye, and Streiff, are supported by a research grant (1R01HS024547) from the Agency for Healthcare Research and Quality (AHRQ) titled “Individualized Performance Feedback on Venous Thromboembolism Prevention Practice.” Mr. Lau, Ms. Shaffer, Drs. Haut, Aboagye, and Streiff, are supported by a contract (CE-12-11-4489) from the Patient-Centered Outcomes Research Institute (PCORI) titled “Preventing Venous Thromboembolism: Empowering Patients and Enabling Patient-Centered Care via Health Information Technology.” Mr. Lau is supported by the Institute for Excellence in Education Berkheimer Faculty Education Grant and a contract (AD-1306-03980) from the Patient-Centered Outcomes Research Institute (PCORI) titled “Patient Centered Approaches to Collect Sexual Orientation/Gender Identity Information in the Emergency Department.” Dr. Popoola has consulted for UCB Pharmaceuticals and operates a research consulting firm (EpiStat-E{\textregistered} Consulting, LLC). Dr. Streiff has received research funding from Boehringer-Ingelheim, Janssen, Portola and Roche and has consulted for Bio2Medical, CSL Behring, Janssen and Merck and has given expert witness testimony in various medical malpractice cases. Dr. Haut receives royalties from Lippincott, Williams, & Wilkins for a book - “Avoiding Common ICU Errors”. Dr. Haut is a paid consultant and speaker for the “Preventing Avoidable Venous Thromboembolism—Every Patient, Every Time” VHA IMPERATIV{\textregistered} Advantage Performance Improvement Collaborative and the Illinois Surgical Quality Improvement Collaborative “ISQIC.” Dr. Haut was the paid author of a paper commissioned by the National Academies of Medicine titled “Military Trauma Care's Learning Health System: The Importance of Data Driven Decision Making” which was used to support the report titled “A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury.” Ms. Farrah Tavakoli, Mr. Matthew Lankiewicz, Drs. Patricia Ross, Peggy Kraus, and Norma Farrow and Ms. Deborah B. Hobson do not have any disclosures to report. Publisher Copyright: {\textcopyright} 2017 Elsevier Ltd",
year = "2017",
month = dec,
doi = "10.1016/j.thromres.2017.10.012",
language = "English (US)",
volume = "160",
pages = "109--113",
journal = "Thrombosis Research",
issn = "0049-3848",
publisher = "Elsevier Limited",
}