ArticlePloS one2026
Implementation of a clinical decision support tool to improve the adequate prescription of low-molecular-weight heparins in non-surgical patients.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundNon-surgical hospitalized patients have an increased risk of developing venous thromboembolism (VTE). This risk can be reduced by thromboprophylaxis with low-molecular-weight heparins (LMWHs), but adherence to thromboprophylaxis guidelines is generally low.
objectivesTo study the effect of implementing a clinical decision support (CDS) tool in the electronic health record on the percentage of adequately prescribed thromboprophylaxis with an LMWH in non-surgical patients at high risk for VTE.
methodsData on the Padua Prediction Score (PPS) and thromboprophylaxis in high-risk non-surgical patients (≥18 years) were collected at different time points before and after the implementation of the intervention consisting of a validated CDS tool. The percentage of adequately prescribed LMWH thromboprophylaxis was described pre- and post-intervention in a stepwise approach, in which both crude and adjusted pre- and post-intervention differences were assessed using an interrupted time series analysis, accounting for potential time trends and autocorrelation.
resultsIn 400 patients included, 200 pre- and 200 post-intervention, the percentage of adequately prescribed LMWH thromboprophylaxis increased from 78% to 91%, an increase of 13% (95% CI: 6%-20%). This effect diminished to 8% (95% CI: -4%-19%) after adjustment for the pre-intervention slope and autocorrelation.
conclusionIn our study, the already high percentage of patients with adequately prescribed LMWH-thromboprophylaxis could potentially be increased further with the implementation of a CDS tool. With increasing amounts of data available in electronic health records, CDS tools might be an efficient and sustainable intervention to improve healthcare quality.
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