OBJECTIVES: A landmark Canadian randomized controlled clinical trial compared treatment of acute proximal vein @entity715 via low-molecular-weight heparin (LMWH) [enoxaparin] administered primarily at home with IV unfractionated heparin (UH) in the hospital. Results demonstrated equivalent safety and efficacy for home care with enoxaparin with a reduction in cost. Our objective was to validate these findings in the routine practice setting of a US health maintenance organization. DESIGN: Retrospective analysis of medical and administrative records of health-plan members meeting inclusion-exclusion criteria of the Canadian trial during the period from 1995 to 1998. SETTING: Staff-model health maintenance organization serving New Mexico. @entity1 : @entity1 presenting as outpatients from 1995 to 1996 or from 1997 to 1998 with acute, proximal @entity1150 ( @entity1150 ) diagnosed by duplex ultrasonography. INTERVENTIONS: Initial anticoagulant therapy of IV UH administered in the hospital (from 1995 to 1996 group, n = 64) or subcutaneous LMWH (enoxaparin) administered primarily at home (from 1997 to 1998 group, n = 65), followed by @entity1229 therapy. RESULTS: No statistically significant differences were observed in the number of recurrent venous @entity1031 (p = 0.36) or @entity548 events (p = 1.0). Mean +/- SD cost per @entity1 was 9,347 dollars +/- 8,469 in the enoxaparin group compared with 11,930 dollars +/- 10,892 in the UH group, a difference of - 2,583 dollars (95% bootstrap-adjusted asymmetrical confidence interval, - 6,147 dollars, + 650 dollars). CONCLUSIONS: Retrospective replication of the Canadian study in a US routine (managed) care setting found similar clinical and economic outcomes. Treatment of acute proximal @entity1150 with enoxaparin in a primarily outpatient setting can be accomplished safely and yields savings through avoidance or minimization of inpatient stays.

Management of acute proximal XXXX : pharmacoeconomic evaluation of outpatient treatment with enoxaparin vs inpatient treatment with unfractionated heparin.

@entity1 :: ('9606', 'Species') :: ['Persons', 'patient', 'PATIENTS'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity1150 :: ('MESH:D020246', 'Disease') :: ['deep vein thrombosis', 'DVT'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolic events'] @entity715 :: ('MESH:D013927', 'Disease') :: ['thrombosis'] @entity1229 :: ('MESH:D014859', 'Chemical') :: ['warfarin']
@entity1150 :: (MESH:D020246,Disease) :: ['deep vein thrombosis']
