Physician alerts to prevent venous thromboembolism

Venous thromboembolism (VTE), which encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common but usually preventable complication of hospitalization associated with substantial mortality, morbidity, and health care costs. Despite published guidelines for the prevention of VTE among hospitalized patients, underutilization of prophylaxis continues to be a problem in the United States, Canada, and worldwide. Although much of the emphasis placed on prevention has focused on improving in-hospital prophylaxis, nearly 75% of patients develop VTE in the outpatient setting. Of these patients, a substantial proportion had undergone surgery or hospitalization in the three months preceding the diagnosis of VTE. While extended out-of-hospital prophylaxis has been validated in the orthopedic and surgical oncology literature, data regarding the prevention of VTE in other hospitalized patient populations after discharge have been limited. In this review article, we discuss decision support strategies for improving VTE prevention during hospitalization and at the time of discharge.