Impact of a clinical pharmacist on ultrasound-guided venous thromboembolism screening in hospitalized COVID-19 patients: a pilot prospective study

Journal of Pharmaceutical Health Care and Sciences

Byars Wells¹  Mark Walsh²  Rashid Z. Khan³  Htay Phyu⁴  Meredith Wierman Schmidt⁴  Daniel H. Fulkerson⁵  Laura Gillespie⁶  Jason Jablonski⁶  Lyndsay Oancea⁷  John E. Stillson⁸  Connor M. Bunch⁸  Faisal Salim Shariff⁸  Abraham Leiser⁸  Anne Grisoli⁸  Jacob Speybroeck⁸ 

[1] Department of Emergency of Medicine, St. Joseph Regional Medical Center, Mishawaka, IN, USA;Department of Emergency of Medicine, St. Joseph Regional Medical Center, Mishawaka, IN, USA;Department of Internal Medicine, St. Joseph Regional Medical Center, 5215 Holy Cross Pkwy, 46545, Mishawaka, IN, USA;Department of Hematology, Michiana Hematology Oncology, Mishawaka, IN, USA;Department of Infectious Diseases, St. Joseph Regional Medical Center, Mishawaka, IN, USA;Department of Neurosurgery, St. Joseph Regional Medical Center, Mishawaka, IN, USA;Department of Quality and Performance Improvement, Saint Joseph Regional Medical Center, Mishawaka, IN, USA;Department of Radiology, St. Joseph Regional Medical Center, Mishawaka, IN, USA;South Bend Campus, Indiana University School of Medicine, South Bend, IN, USA;

关键词: COVID-19;    Anticoagulation;    Venous thromboembolism;    Hypercoagulable;    Clinical pharmacist;    Ultrasound;   

DOI  :  10.1186/s40780-021-00201-2

来源: Springer

【 摘 要 】

BackgroundThe recognition, prevention and treatment of venous thromboembolism (VTE) remains a major challenge in the face of the recent COVID-19 pandemic which has been associated with significant cardiovascular, renal, respiratory and hematologic complications related to hypercoagulability. There has been little literature thus far on the utility of screening ultrasound and the role of the clinical pharmacist in treating these patients.MethodsWe present a prospective pilot program of thirty-one consecutive COVID-19 patients who were provided four extremity screening ultrasounds for VTE on admission. This was coordinated by a clinical pharmacist as part of a multidisciplinary approach. Quantitative and qualitative data were recorded with the goal of describing the utility of the clinical pharmacist in ultrasound screening. Data collected include demographics, information on clinical symptoms or signs at presentation, and laboratory and radiologic results during the hospitalization from each individual electronic medical record.ResultsNine of the thirty-one patients presented with VTE. Of the nine patients, there were twenty-two total clotted vessels, all of which were asymptomatic. The clinical pharmacist, as the coordinator for a multidisciplinary COVID-19 associated coagulopathy management team, drafted a screening and treatment protocol for anticoagulation prophylaxis and therapy of VTE after ultrasound findings.ConclusionVTE screening of hospitalized COVID-19 patients reveals a significant number of asymptomatic VTEs and justifies diagnostic, prophylactic, and treatment measures coordinated by a clinical pharmacist.

【 授权许可】

CC BY