[Preventive treatment of thrombosis: audit on heparin prescription]

An audit has been carried out, in a French general hospital, studying the use of heparins in preventive indications, to assess concordance between prescriptions and thrombotic risk, before and one year after the diffusion of national guidelines. Platelet monitoring frequency has also been studied. On a defined day, 550 patients were admitted, and 113 treated with preventive heparinotherapy (low molecular-weight heparin: 98 per cent). 52.2 per cent of patients received a correct regimen, while 4.4 per cent of underprescriptions and 43.4 per cent of overprescriptions were observed. Platelet monitoring protocol was respected in 44 per cent of cases, while it was insufficient for 41 per cent and not carried out in 15 per cent. The results of this study have been communicated to all the prescriptors. Another audit done one year later showed that 81 per cent of doses were adapted to the thrombotic risk, 2 per cent were too low, and 17 per cent too high. The efficiency of this kind of process shows that it should be generalized to all the sensitive therapeutic classes.