Adherence to Venous Thromboembolism Prophylaxis Guidelines in Medical Patients.

Background Venous thromboembolism (VTE) is a major cause of preventable morbidity and mortality among hospitalized medical patients. Despite the availability of validated risk assessment strategies and established prophylactic measures, variation in clinical practice persists, leading to both under- and over-utilisation of thromboprophylaxis. Methods A retrospective single-centre clinical audit was conducted over a two-month period at Letterkenny University Hospital, Ireland. Medical inpatients were reviewed 24 hours after admission. VTE risk was assessed using the Padua Prediction Score alongside bleeding risk evaluation. Prescribed pharmacological and mechanical thromboprophylaxis were compared with local hospital guidelines. Results A total of 100 patients were included (mean age 70.9 ± 19.1 years). Fifty-eight patients (58%) were classified as high VTE risk. Among high-risk patients, 37 (64%) received inappropriate prophylaxis. Among low-risk patients (n = 42), 24 (57.1%) were managed inappropriately, with unnecessary pharmacological prophylaxis being the most common reason for non-adherence. Contributing factors included undocumented weight, incorrect dose adjustment, and absence of documented VTE risk assessment. Conclusions Adherence to VTE prophylaxis guidelines was suboptimal, with both under- and over-prescription identified. Structured risk assessment tools and improved admission documentation may enhance compliance and patient safety.