Evidence map›Paper›PMID 38905283›Full record

ArticlePloS one2024

Adoption of antithrombotic stewardship and utilization of clinical decision support systems-A questionnaire-based survey in Dutch hospitals.

Jetske Graafsma, Joanna E Klopotowska, Hieronymus J Derijks, Ewoudt M W van de Garde, Rien H L Hoge, Marieke J H A Kruip, Karina Meijer, Fatma Karapinar-Carkit, Patricia M L A van den Bemt

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jetske GraafsmaDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.ORCID 0009-0003-5275-1199
Joanna E KlopotowskaDepartment of Medical Informatics Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Hieronymus J DerijksDepartment of Pharmacy, Jeroen Bosch Hospital, Den Bosch, the Netherlands.
Ewoudt M W van de GardeDepartment of Pharmacy, St. Antonius Hospital, Nieuwegein, Utrecht, the Netherlands.
Rien H L HogeDepartment of Pharmacy, Wilhelmina Hospital, Assen, the Netherlands.
Marieke J H A KruipDepartment of Hematology, Erasmus MC, Erasmus University medical center, Rotterdam, the Netherlands.ORCID 0000-0002-0265-4871
Karina MeijerDepartment of Hematology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Fatma Karapinar-CarkitDepartment of Clinical Pharmacy & Toxicology, Maastricht University Medical Center+, Maastricht, the Netherlands.
Patricia M L A van den BemtDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Antithrombotics require careful monitoring to prevent adverse events. Safe use can be promoted through so-called antithrombotic stewardship. Clinical decision support systems (CDSSs) can be used to monitor safe use of antithrombotics, supporting antithrombotic stewardship efforts. Yet, previous research shows that despite these interventions, antithrombotics continue to cause harm. Insufficient adoption of antithrombotic stewardship and suboptimal use of CDSSs may provide and explanation. However, it is currently unknown to what extent hospitals adopted antithrombotic stewardship and utilize CDSSs to support safe use of antithrombotics. A semi-structured questionnaire-based survey was disseminated to 12 hospital pharmacists from different hospital types and regions in the Netherlands. The primary outcome was the degree of antithrombotic stewardship adoption, expressed as the number of tasks adopted per hospital and the degree of adoption per task. Secondary outcomes included characteristics of CDSS alerts used to monitor safe use of antithrombotics. All 12 hospital pharmacists completed the survey and report to have adopted antithrombotic stewardship in their hospital to a certain degree. The median adoption of tasks was two of five tasks (range 1-3). The tasks with the highest uptake were: drafting and maintenance of protocols (100%) and professional's education (58%), while care transition optimization (25%), medication reviews (8%) and patient counseling (8%) had the lowest uptake. All hospitals used a CDSS to monitor safe use of antithrombotics, mainly via basic alerts and less frequently via advanced alerts. The most frequently employed alerts were: identification of patients using a direct oral anticoagulant (DOAC) or a vitamin K antagonist (VKA) with one or more other antithrombotics (n = 6) and patients using a VKA to evaluate correct use (n = 6), both reflecting basic CDSS. All participating hospitals adopted antithrombotic stewardship, but the adopted tasks vary. CDSS alerts used are mainly basic in their logic.

Indexed as

Decision Support Systems, ClinicalFibrinolytic AgentsHospitalsHumansNetherlandsPharmacistsPharmacy Service, HospitalSurveys and QuestionnairesFibrinolytic Agents

Identifiers

PMID38905283
PMCPMC11192363

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.