2011 Top Game Changers in Primary Care

Carol Peckham; Sandra A. Fryhofer, MD; R. Brian Haynes, MD, PhD; Charles P. Vega, MD

Disclosures

November 23, 2011

In This Article

10. ACP Issues VTE Prophylaxis Guidelines for Medical Inpatients

The top 10 game changing studies listed in the table of contents were identified by members of our primary care advisory boards as research or events that had the potential to change practice. In addition, some were selected from Medscape's Best Evidence Review series and also others were among the top 5 accessed this year by primary care physicians through the McMaster Premium Literature Service. They also received at least 6 out of 7 stars for clinical relevance.

In November 2011, The American College of Physicians (ACP) published recommendations on preventing venous thromboembolism (VTE) for hospitalized medical patients and patients with acute stroke.[1] The guideline stated that before starting therapy to prevent VTE, physicians should evaluate the risk for thromboembolism and bleeding among medical, nonsurgical inpatients.

"The evidence does not support routine VTE prophylaxis in patients hospitalized for medical illnesses, including stroke," lead guideline author Amir Qaseem, MD, PhD, MHA, ACP Director of Clinical Policy, said in a news release. "If a patient is at risk for VTE, the [ACP] recommends that physicians prescribe heparin or related blood thinners, unless the assessed risk of bleeding outweighs likely benefits." Many hospitals routinely prescribe antiplatelet agents or anticoagulants to medical inpatients because most hospitalized patients have 1 or more risk factors for VTE, but these medications are associated with increased risk for bleeding. Read the full Medscape news story.

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