Thrombus - 2007

Prevention of VTE in hospitalised patients – the CMO’s report
Roopen Arya
pp 1-4
The Chief Medical Officer (CMO) for England, Sir Liam Donaldson, recently published the report of the independent expert working group on the prevention of venous thromboembolism (VTE) in hospitalised patients. This is the culmination of a political process initiated in March 2005 by the publication of the House of Commons Health Committee report that concluded that much more needed to be done to prevent avoidable deaths from VTE.

Perioperative warfarin management
Carol Arbuthnot and Will Lester
pp 5-6
Warfarin has been in clinical use for over 60 years. The National Institute for Health and Clinical Excellence (NICE) recommends that 1.4% of the population in the UK require anticoagulant therapy. Curiously, there are still no published data from randomised trials to inform clinicians about the most effective management strategies for oral anticoagulation in the perioperative period. Any management plan for an individual patient should take into account the risk of thrombosis if anticoagulation is omitted, the risk of bleeding if used, and the preference of the clinician doing the procedure.

Herbal medicine and oral anticoagulants
Sarah Bond, E Sarah Green and Lyn Williamson
pp 7-8
There is a misconception among patients that herbal medicines are safe and do not interfere with prescribed medicines. However, many have been shown to directly interact, or have the potential to interact, with oral anticoagulants and others may have an antiplatelet effect. The use of complementary therapies is increasing and herbal medicines represent the most popular branch of treatment. Patients are often not asked about, or may not admit to, concurrent herbal medicine use, but studies have shown that many anticoagulated patients do take herbal medicines.

Anticoagulants – the NPSA’s view
Bruce Warner
pp 9-11
Anticoagulants have been highlighted as one of the groups of medicines most likely to cause harm to patients.1–3 Much of this harm is the result of avoidable medication error, as demonstrated by both the published literature and reports to the National Patient Safety Agency (NPSA) National Reporting and Learning System (NRLS). Indemnity and litigation bodies also identify anticoagulants as a major source of claims resulting from error.

Spring 2007, Volume 11 Number 1