An Impact Evaluation of an Education Bundle for Patients at Risk of Developing Venous Thromboembolism

Plain language summary In a previous study, an education bundle was designed to increase administration of medication to prevent blood clotting among hospitalized patients at risk of venous thromboembolism (VTE). The education bundle led to a decrease in patients missing those needed doses of medication. The current study estimates the economic impacts of a nationwide rollout of the education bundle for patients at risk of VTE. The results show that if the education bundle were rolled out nationally, it could result in 134,000 fewer VTEs, 552,000 fewer days spent in the hospital and 19,000 fewer deaths over 5 years. As a result of reduced medical care, less time off work, and informal caregiving needed, societal cost savings could be as much as US$2.8 billion. Tweetable abstract A Markov model was designed to estimate a nationwide rollout of an education bundle that increased appropriate administration of prophylaxis for patients at risk of venous thromboembolism (VTE). Results suggest that universal exposure to the bundle could decrease societal costs. Aim: Among hospitalized patients, venous thromboembolism (VTE) is a preventable cause of morbidity and mortality. This study analyzed the effects of a large-scale adoption of a prompt response and education protocol to increase VTE prophylaxis adherence in the USA. Methods: A Markov model was developed that simulates outcomes and costs of delivering a VTE education bundle versus not, to hospitalized at-risk patients. Results: The education bundle could avert more than 134,000 VTEs, 552,000 hospital days and 19,000 deaths over 5 years. Patients could save 13 million hours in work absenteeism and travel time, valued at US$237 million. Total societal savings could amount to US$2.8 billion. In scenario analyses with assumed lower-effectiveness estimates, the bundle averts 16,000 VTEs, 67,000 hospital days and 2000 deaths. Conclusion: A nationwide rollout of an education bundle to reduce missed doses of prescribed prophylaxis could improve quality of care, resulting in a decline in VTEs and mortality.