Diffusion of Use of Low Molecular Weight Heparin for Thrombosis on the Medicine Services
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 5/19/2016 |
| Start Date: | February 2001 |
| End Date: | January 2017 |
The purpose of this research is to gain insight into the way in which physicians adopt new
practice techniques. In particular, we are interested in how medical innovations diffuse
throughout social networks. We wish to examine the diffusion of Low Molecular Weight Heparin
(LMWH) use for Deep Vein Thrombosis (DVT) throughout the social network of general internal
medicine interns, residents, and attendings at the University of Chicago Hospital. In
numerous clinical trials, LMWH has been demonstrated to be as effective as unfractionated
heparin as a bridge to long-term anticoagulation therapy with Coumadin, with the added
benefit of early discharge from the hospital with easy dosing, no need for monitoring, and
home therapy. A DVT critical pathway was established at the U of C in 1998, and LMWH was
used off-label for that purpose beginning in 1997. However, it is unclear how quickly the
use of LMWH was adopted by the physicians on the general medicine services, or whether there
exists a pattern for this adoption.
practice techniques. In particular, we are interested in how medical innovations diffuse
throughout social networks. We wish to examine the diffusion of Low Molecular Weight Heparin
(LMWH) use for Deep Vein Thrombosis (DVT) throughout the social network of general internal
medicine interns, residents, and attendings at the University of Chicago Hospital. In
numerous clinical trials, LMWH has been demonstrated to be as effective as unfractionated
heparin as a bridge to long-term anticoagulation therapy with Coumadin, with the added
benefit of early discharge from the hospital with easy dosing, no need for monitoring, and
home therapy. A DVT critical pathway was established at the U of C in 1998, and LMWH was
used off-label for that purpose beginning in 1997. However, it is unclear how quickly the
use of LMWH was adopted by the physicians on the general medicine services, or whether there
exists a pattern for this adoption.
The design of our study is retrospective in nature. We are interested primarily in the use
of LMWH in patients admitted to the general medicine services between January 1, 1997 and
February 1, 2001 with a primary and secondary diagnosis related to Venous Thromboembolism,
including specific ICD-9 codes.
Using a data abstraction form, we gather the following information: 1) patient demographics,
2) identity of the attending, resident, and interns caring for the patient, 3) whether the
patient had any absolute or relative contraindications for receiving LMWH, as delineated by
the DVT critical pathway, including insurance status and 4)how the patient was treated for
his/her condition. To examine whether the identity of the primary care physician affects
whether LMWH is given, we also collect the name of the primary care physician if it is
listed on the chart.
of LMWH in patients admitted to the general medicine services between January 1, 1997 and
February 1, 2001 with a primary and secondary diagnosis related to Venous Thromboembolism,
including specific ICD-9 codes.
Using a data abstraction form, we gather the following information: 1) patient demographics,
2) identity of the attending, resident, and interns caring for the patient, 3) whether the
patient had any absolute or relative contraindications for receiving LMWH, as delineated by
the DVT critical pathway, including insurance status and 4)how the patient was treated for
his/her condition. To examine whether the identity of the primary care physician affects
whether LMWH is given, we also collect the name of the primary care physician if it is
listed on the chart.
Inclusion Criteria:
- Patients admitted to General Medicine Services with a primary or secondary diagnosis
related to venous thromboembolism
Exclusion Criteria:
- Non-General Medicine Services patients
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