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Journal de Pharmacie Clinique

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Good use of danaparoide treatment: a physician, pharmacist and biologist collaboration example Volume 26, issue 3, Septembre 2007

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Authors
Service pharmacie, CHU Bordeaux, Pessac, Laboratoire d’hémobiologie, CHU Bordeaux, Pessac, Département anesthésie réanimation, CHU Bordeaux, Pessac

Generally, facing patients with clinically suspected heparin-induced thrombocytopenia, substitution danaparoid treatment is directly established because of potential life threatening complications and difficulty to obtain a rapid biologic diagnosis. The setting of a prescription and delivery management proceeding has permitted to rationalize diagnosis and treatment of these disease. By objective and concerted estimation of heparin-induced thrombocytopenia risk, the substitution treatment will be started or not. At first, the medicine delivery has been bounded to pre-test clinical score (4T’s) and biologic diagnostic tests realization and so, probabilist treatment has been avoided in more than 60% cases. After local and national evaluation, rapid detection test PaGIA Diamed ® has permitted to sharpen more diagnostic strategy. Before treatment instauration, direct exclusion rate reaches now 81,5%. After two years, the medicine good use process leads to 58% fall in danaparoid use and more than 30 000 € savings. But, beyond diagnosis means, this amelioration process depends on hospital staff involvement which aim is to treat only patients with objective heparin-induced thrombocytopenia.