VTE Prophylaxis Guidelines in Hospitalized Elders

Study Overview
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Brief Summary
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Guideline directed use of pharmacologic Venous thromboembolism (VTE) prophylaxis emphasizes mobility evaluation. Mobility is a key component of risk stratification. Poor mobility evaluation by providers may be a significant barrier to appropriate use of VTE prophylaxis. The investigators aim is to propose to determine whether level of mobility during hospitalization is being used to influence use and duration of VTE prophylaxis among medically ill hospitalized elders. To achieve this aim, the investigator will collect prospective observational data to objectively measure inpatient mobility using patient mounted accelerometers during patient hospital stays. The investigator's goal is to improve the appropriateness of use of VTE prophylaxis among those in which the risks of harm may outweigh the benefit. Results from this study will provide important insights about use of risk assessment, and the relationship between patient mobility and VTE prophylaxis. These results are critical to understanding how to take the next steps toward improving the appropriate use and safety of anticoagulants in hospitalized older adults. Information from this study could be used in future proposals to study interventions to ultimately improve hospital practice in the care of older adults.

Official Title
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Adherence to Venous Thromboembolism Prophylaxis Guidelines in Hospitalized Elders

Conditions
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Venous Thromboembolism

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age of 60 or older Admitted to General Medicine at Duke University Exclusion Criteria: Clear contraindications to pharmacologic VTE prophylaxis Receiving surgery during their index hospital stay On observation admission status On negative pressure room respiratory isolation Wrist site is not available, i.e. wearing bilateral wrist IVs, skin breakdown at the time of screening Ankle site is not available, i.e. patients with leg ulcer at the time of screening Lacking decision-making ability (such as from severe cognitive impairment) and no LAR available Non-English speakers

Ages Eligible for Study
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Minimum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Prospective<br>A sample of 120 patients aged 60 years or older admitted to General Medicine at Duke University Hospital will be enrolled in the prospective cohort study. A convenience sample will be derived from a randomized daily list of general medicine admissions; weekend admissions will be excluded as these patients will not be captured within 24 hours of hospital admission. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total number of minutes of activity (using objective accelerometer data). |  | Length of hospital stay or up to 7 days during the patient's hospital stay. | 
| Total number of minutes of inactivity (using objective accelerometer data). |  | Length of hospital stay or up to 7 days during the patient's hospital stay. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total number of steps (using objective accelerometer data). |  | Length of hospital stay or up to 7 days during the patient's hospital stay. |