Outcomes of a Comprehensive, Pharmacist-Managed Injectable Anticoagulation Discharge Program for the Prophylaxis and Treatment of Venous Thromboembolism

Background:Safe and effective transition of patients receiving injectable anticoagulation, from an inpatient to an outpatient setting, requires patient education, prescription coordination, and appropriate follow-up.Objective:To evaluate a long-standing, hospital-wide, pharmacist-managed injectable anticoagulation discharge program at an urban academic medical center.Methods:This observational study included adults discharged on an injectable anticoagulant between December 1, 2008, and February 28, 2009. The primary endpoint was program adherence, defined as percent of discharged patients whose anticoagulation therapy was coordinated by a pharmacist. Secondary endpoints included duration of patient counseling and medication procurement (including confirmation of current home supply or need for complete procurement of a full/new prescription); length of hospital stay for patients with a primary diagnosis of venous thromboembolism (VTE); and VTE recurrence and bleeding rates at 3 months. Descriptive statist...