PF332 THE EFFECT OF ANTITHROMBOTIC STEWARDSHIP ON THE EFFICACY AND SAFETY OF ANTITHROMBOTIC THERAPY DURING AND AFTER HOSPITALIZATION IN TWO DUTCH HOSPITALS

• Published in: HemaSphere Vol. 3; no. S1; pp. 118 - n/a
• Main Authors: Dreijer, A., Kruip, M., Diepstraten, J., Brouwer, R., Croles, N., Kragten, E., Leebeek, F., Bemt, P.
• Format: Journal Article
• Language: English
• Published: 01.06.2019
• ISSN: 2572-9241; 2572-9241
• DOI: 10.1097/01.HS9.0000559540.58960.ac

Background: Although the benefits of antithrombotic drugs are indisputable, they carry a high risk for patient safety. Studies on the implementation and effectiveness of a hospital‐based multidisciplinary antithrombotic team on bleeding and thrombotic outcomes are scarce. Aims: Main aim is to investigate the effect of implementing a hospital‐based multidisciplinary antithrombotic team on the efficacy and safety of antithrombotic therapy during and after hospitalization. Secondary aims are to determine the effect of the multidisciplinary team on severity of bleeding, all‐cause mortality and length of hospitalization. Methods: Design: Prospective, observational multicenter cohort study. Setting: Patients admitted to Erasmus University Medical Center and Reinier de Graaf Hospital between October 2015 and December 2017, using one or more therapeutically dosed anticoagulants. Intervention: Implementation of a hospital‐based multidisciplinary antithrombotic team. Primary outcome: proportion of patients with a composite end point consisting of ≥1 bleeding or ≥1 thrombotic event from hospitalization until 3 months after hospitalization. Secondary outcomes: proportion of patients with a major and non‐major bleeding event, all‐cause mortality and length of hospitalization before and after implementation of the multidisciplinary antithrombotic team. Statistical analysis: For analysis of the primary outcome we used segmented regression analysis for the interrupted time series data. For the secondary outcomes logistic regression analysis was used. T‐test analysis was performed for the length of hospitalization. Results: 941 patients were included in the usual care period and 945 patients in the intervention period. Introduction of the multidisciplinary antithrombotic team led to a significant reduction in the proportion of patients with the primary outcome (−1.83% (95% CI: −2.58%; −1.08%). Lower all‐cause mortality (odds ratio [OR] 0.71, 95% confidence interval [95% CI] 0.53–0.95) was observed after introduction of the multidisciplinary antithrombotic team. No significant effect of the intervention was found for the severity of bleeding and mean length of hospital stay. Summary/Conclusion: Introducing a multidisciplinary antithrombotic team contributes to patient safety.