Comment on Millar: The application of appropriate prophylaxis for venous thromboembolism (VTE) is recognised as an important patient safety measure. In a systematic review ranking 79 safety interventions, the Agency for Healthcare Research and Quality in the United States found that, based on the strength of overwhelming evidence that thromboprophylaxis reduces adverse patient outcomes and decreases overall costs, the highest-ranked safety practice was the appropriate use of prophylaxis to prevent VTE.1 However, it has been shown that, worldwide, the application of appropriate VTE prophylaxis is underutilised.2
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- 1. Shojania KG, Duncan BW, McDonald KM, Wachter RM (editorial board); University of California at San Francisco–Stanford University Evidence-based Practice Center. Making health care safer: a critical analysis of patient safety practices. Evidence Report/Technology Assessment No. 43. Rockville, Md: Agency for Healthcare Research and Quality, 2001. http://www.ahrq.gov/clinic/ptsafety/pdf/ptsafety.pdf (accessed Feb 2009).
- 2. Cohen AT, Tapson VF, Bergmann JF, et al. Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE Study): a multinational cross-sectional study. Lancet 2008; 371: 387-394.
- 3. Nicolaides AN, Fareed J, Kakkar AK, et al. Prevention and treatment of venous thromboembolism: International Consensus Statement (guidelines according to scientific evidence). Int Angiol 2006; 25: 101-161.
- 4. Geerts WH, Pineo GF, Heit JA, et al. Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126 (3 Suppl): 338S-400S.
- 5. Geerts WH, Bergqvist D, Pineo GF, et al. Prevention of venous thromboembolism: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th edition). Chest 2008; 133 (6 Suppl): 381S-453S.
I have received speaker fees and travel assistance from Sanofi-Aventis and GlaxoSmithKline, and a speaker fee from Bayer Schering Pharma.