VTE Prophylaxis Guidelines in Hospitalized Elders

Adherence to Venous Thromboembolism Prophylaxis Guidelines in Hospitalized Elders

Guideline directed use of pharmacologic Venous thromboembolism (VTE) prophylaxis 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. The investigators aim is to propose 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, the investigator will collect prospective observational data to objectively measure inpatient mobility using patient mounted accelerometers during patient hospital stays.

The investigator's 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 this 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.

Study Overview

• Status: Completed
• Conditions: Venous Thromboembolism

• Study Type: Observational
• Enrollment (Actual): 79

Contacts and Locations

Study Locations

• United States
  • North Carolina
    • Durham, North Carolina, United States, 27701
      • Duke University Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 60 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

A sample of patients aged 60 years or older admitted to General Medicine at Duke University Hospital will be enrolled in a prospective cohort study.

Description

Inclusion Criteria:

1. Age of 60 or older
2. Admitted to General Medicine at Duke University

Exclusion Criteria:

1. Clear contraindications to pharmacologic VTE prophylaxis
2. Receiving surgery during their index hospital stay
3. On observation admission status
4. On negative pressure room respiratory isolation
5. Wrist site is not available, i.e. wearing bilateral wrist IVs, skin breakdown at the time of screening
6. Ankle site is not available, i.e. patients with leg ulcer at the time of screening
7. Lacking decision-making ability (such as from severe cognitive impairment) and no LAR available
8. Non-English speakers

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Prospective; A sample of 120 patients aged 60 years or older admitted to General Medicine at Duke University Hospital will be enrolled in the prospective cohort study. A convenience sample will be derived from a randomized daily list of general medicine admissions; weekend admissions will be excluded as these patients will not be captured within 24 hours of hospital admission.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Total number of minutes of activity (using objective accelerometer data).	Length of hospital stay or up to 7 days during the patient's hospital stay.
Total number of minutes of inactivity (using objective accelerometer data).	Length of hospital stay or up to 7 days during the patient's hospital stay.

Secondary Outcome Measures

Outcome Measure	Time Frame
Total number of steps (using objective accelerometer data).	Length of hospital stay or up to 7 days during the patient's hospital stay.

Collaborators and Investigators

• Sponsor: Duke University
• Collaborators: National Institutes of Health (NIH); National Institute on Aging (NIA); Hartford Foundation; T. Franklin Williams Scholars
• Investigators: Principal Investigator: Juliessa Pavon, Duke University

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2016
• Primary Completion (Actual): March 4, 2017
• Study Completion (Actual): March 4, 2017

Study Registration Dates

• First Submitted: January 17, 2017
• First Submitted That Met QC Criteria: January 17, 2017
• First Posted (Estimate): January 19, 2017

Study Record Updates

• Last Update Posted (Actual): November 8, 2021
• Last Update Submitted That Met QC Criteria: November 3, 2021
• Last Verified: October 1, 2021

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Embolism and Thrombosis; Thromboembolism; Venous Thromboembolism
• Other Study ID Numbers: Pro00056253; R03AG048007-01 (U.S. NIH Grant/Contract)