A new survey of patients showing that less than one-third reported receiving DVT prophylaxis, even though 2 out of every 5 had a family member who previously had an embolism clot in their leg or lung, is a sign physicians need to improve their communication skills, one hospitalist says.
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The survey, conducted online by the National Blood Clot Alliance (NCBA) and presented at HM11, queried 500 patients with a length of stay of three days or higher. According to the survey, only 28% of patients had heard of DVT when the term was used, and just 15% knew pulmonary embolism when the term was used. In comparison, 83% knew what a blood clot was and 99% knew it could be life-threatening. Still, 46% said their doctor did not provide info about blood-clot-related risks.
Greg Maynard, MD, MSc, SFHM, chief of the Division of Hospital Medicine at the University of California at San Diego, says the results should serve as a wake-up call to hospitalists and other physicians. "They don’t speak the language," says Dr. Maynard, a member of the NCBA’s Medical and Scientific Advisory Board. "If we use that terminology with them, we fail. … The first part of this puzzle is how we educate our patients."
Dr. Maynard says increased use of prophylaxis would help reduce care delivery costs and increase efficiency by eliminating preventable DVT or VTE incidences. Hospitalists are "well positioned" to lead the effort, but a few steps must happen first, he says. These changes require institutional commitment to do everything from adding prophylaxis checks to order sets to adopting new safety checklists to patient brochures explaining symptoms of blood clots. In addition, according to Dr. Maynard, baseline measurements must be set to determine what factors will classify patients as low-risk versus high-risk. Everyone above the low-risk line should receive prophylaxis, be it ambulation, compression stockings, or anticoagulant therapies, he says.
"It’s all part of a bundle," Dr. Maynard says. "Any one of these things by themselves would not work as well."