Alerting Providers at Patient Hospital Discharge to Consider Prescribing Rivaroxaban to Reduce Venous Thromboembolism

Description

A new algorithm derived from only patient age and components of the complete blood count and basic metabolic panel can identify patients discharged from the hospital who may benefit from a blood thinner (called rivaroxaban) to decrease their risk of blood clots, and for whom the risk of bleeding is minimal. The purpose of this study is to evaluate the use of a pop-up alert, which will be seen by clinicians when a discharging patient has been identified as being someone for whom the risk of blood clots is high, but for whom bleeding risk is estimated to be low. The pop-up alert will be enabled in a sequential fashion for each group of hospitals in 1 month blocks. We will look to see if the pop-up alert changes the number of patients who receive rivaroxaban. We will also measure the outcomes of blood clots and bleeding among all discharging patients.

Conditions

Venous Thromboembolic Disease, Pulmonary Embolism and Thrombosis, Deep Vein Thrombosis, Hospitalism

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Study Overview

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Study Details

Study overview

A new algorithm derived from only patient age and components of the complete blood count and basic metabolic panel can identify patients discharged from the hospital who may benefit from a blood thinner (called rivaroxaban) to decrease their risk of blood clots, and for whom the risk of bleeding is minimal. The purpose of this study is to evaluate the use of a pop-up alert, which will be seen by clinicians when a discharging patient has been identified as being someone for whom the risk of blood clots is high, but for whom bleeding risk is estimated to be low. The pop-up alert will be enabled in a sequential fashion for each group of hospitals in 1 month blocks. We will look to see if the pop-up alert changes the number of patients who receive rivaroxaban. We will also measure the outcomes of blood clots and bleeding among all discharging patients.

eVTE (Electronic Venous Thromboembolism): A Cluster, Randomized, Step-wedge Type II Hybrid Study of an Alert Recommending Extended Duration Thromboprophylaxis for At-risk Discharging Medical Patients to Prevent VTE.

Alerting Providers at Patient Hospital Discharge to Consider Prescribing Rivaroxaban to Reduce Venous Thromboembolism

Condition
Venous Thromboembolic Disease
Intervention / Treatment

-

Contacts and Locations

Murray

Intermountain Medical Center, Murray, Utah, United States, 84107

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * Discharging clinician must be in one of the following iCentra electronic health record (Cerner, Kansas City, MO) positions:
  • * Physician, nurse practitioner, or physician assistant hospitalist
  • * Physician internal medicine
  • * Physician family medicine
  • * Patient age ≥ 18 years.
  • * The encounter must be inpatient.
  • * A signed hospital discharge order must be present.
  • * eVTE target population criteria (increased venous thromboembolism risk, low bleeding risk) must be met
  • * Pregnant during encounter
  • * Discharge order completed by ineligible clinician type
  • * Exclude all cases where the patient is being actively prescribed and intended to be discharged on the following qualifying anticoagulant medications, regardless of dose form or dosing regimen (i.e., they have an active prescription for one of these medications):
  • * Apixaban
  • * Dabigatran
  • * Dalteparin
  • * Enoxaparin
  • * Edoxaban
  • * Betrixaban
  • * Fondaparinux
  • * Rivaroxaban
  • * Warfarin
  • * Creatinine clearance \<30 milliliters/minute based on last-available eligible serum creatinine value preceding discharge
  • * Estimated creatine clearance based on actual body weight (preferred) ((140 - age years) \* measured weight kilograms) / (72.0 \* serum creatine milligrams/deciliter) (\*0.85 if female)) = milliliters/minute
  • * If measured body weight not available, then based on ideal body weight ((140 - age years) \* ideal body weight kilograms) / (72.0 \* serum creatine milligrams/deciliter) (\*0.85 if female)) = milliliters/minute

Ages Eligible for Study

18 Years to 110 Years

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Scott C. Woller, MD,

Scott C. Woller, MD, PRINCIPAL_INVESTIGATOR, Intermountain Health

Study Record Dates

2025-09-30