Evaluation of Use and Safety of Using Parentral Anti-Coagulants in Critically Ill Patients in Tertiary Care Hospital, India

Objective:  to find out the appropriateness of prescribing different types of parenteral anticoagulants in critically ill patients and identifying the patterns of thromboprophylaxis. Methodology: This cross-sectional prospective study of on appropriateness of prescribing anti-coagulants has been carried out in a number of 213 patients. The study was conducted over 6 months (February to July 2016) at the Tertiary Care Hospital, India. As per inclusion criteria, from the day of admission to the day of discharge the patient’s treatment charts have been followed. Guidelines for the use of anti-coagulants have been summed up and checked up during the prognosis of treatment. Mechanical prophylaxis of VTE and Pharmacological prophylaxis have been studied. The mismatch of guidelines and the treatment is being followed and adherence with the guidelines is undertaken. Result: The appropriateness of prescribing anti-coagulants have been determined based on the patterns of thromboprophylaxis, out 0f 213 patients, 172 patients received UFH ,65 patients was on Enoxaparin, and no one were on Fondaparinux. The evaluations are been made with respect to guidelines, the mean ratio which follows the guidelines identified as just 47.31%, where some have filtered through the certain diagnostic criteria .The risk over VTE has also evaluated .The outcome measures shows that prescribing appropriate regimen will endorse the risk of VTE .The cost effectiveness of management of VTE prophylaxis has been studied ,the data shows more effectiveness is shown by Enoxaparin, as the QOL has improved. Conclusion: This study revealed appropriateness of prescribing in VTE prophylaxis the best and effective for improving the prescription pattern and QOL of patients. In this study, the diagnostic criteria and guidelines mandatory for choosing the appropriate regimen for thromboprophylaxis have been considered, where being evaluated, cost effectiveness of each drug are also studied. Possible recommendations have been made.