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, Taylor Robichaux, PharmD, BCPS Ochsner LSU Health Shreveport–Academic Medical Center , Shreveport, LA , USA Search for other works by this author on: Oxford Academic Kristyn Edwards, PharmD, MBA, BCPS Ochsner LSU Health Shreveport–Academic Medical Center , Shreveport, LA , USA Search for other works by this author on: Oxford Academic Ashley Carter, PharmD, BCPS The University of Tennessee Medical Center , Knoxville, TN , USA Search for other works by this author on: Oxford Academic Andrea Washington, PharmD, BCPS Ochsner LSU Health Shreveport–Academic Medical Center , Shreveport, LA , USA Search for other works by this author on: Oxford Academic Shelby Brooks, PharmD, BCPS Ochsner LSU Health Shreveport–Academic Medical Center , Shreveport, LA University of Louisiana at Monroe College of Pharmacy , Monroe, LA , USA Address correspondence to Dr. Brooks (spbrooks23@gmail.com). Search for other works by this author on: Oxford Academic
American Journal of Health-System Pharmacy, Volume 81, Issue Supplement_4, 1 September 2024, Pages S144–S151, https://doi.org/10.1093/ajhp/zxae068
Published:
15 March 2024
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Published:
15 March 2024
Corrected and typeset:
04 April 2024
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Taylor Robichaux, Kristyn Edwards, Ashley Carter, Andrea Washington, Shelby Brooks, Analysis of appropriateness and safety when discharging patients on triple-antithrombotic therapies, American Journal of Health-System Pharmacy, Volume 81, Issue Supplement_4, 1 September 2024, Pages S144–S151, https://doi.org/10.1093/ajhp/zxae068
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Abstract
Purpose
To analyze the appropriateness of triple-antithrombotic therapy based on the 2020 American College of Cardiology (ACC) consensus statement while evaluating safety outcomes for patients with respect to adverse events.
Methods
A single-center, retrospective chart review was conducted using electronic medical records from December 18, 2020, to August 31, 2022. The primary endpoint was the rate of appropriateness for triple-antithrombotic therapy in patients discharged from Ochsner LSU Health Shreveport. Appropriateness was a composite endpoint extrapolated from the 2020 ACC consensus statement. For therapy to be defined as appropriate, patients had to have had the correct therapy indication, medications, dosing, and 30-day duration. Secondary safety endpoints included the percentage of patients rehospitalized at 14 and 30 days, the rate of major bleeding events, and the percentage of patients on gastrointestinal prophylaxis while on triple-antithrombotic therapy.
Results
A total of 93 patients were included in the study, of whom 31 (33%) received appropriate triple-antithrombotic therapy. Prolonged duration of triple-antithrombotic therapy was the most common reason that therapy did not meet the primary endpoint. The readmission rate due to bleeding was 2.2% at 14 days and 6.5% at 30 days. Within 30 days of initiation of triple therapy, 4.3% of patients endured major bleeding as defined by the International Society on Thrombosis and Hemostasis and 2 patients died.
Conclusion
In this single-center study, triple-antithrombotic therapy appropriately adhered to the 2020 ACC consensus statement for one-third of patients discharged on this therapy.
anticoagulants, anticoagulation, antiplatelets, antithrombotic agents, dual antiplatelet therapy, triple therapy
© American Society of Health-System Pharmacists 2024. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)
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