Journal de Pharmacie Clinique
MENUGood use of danaparoide treatment: a physician, pharmacist and biologist collaboration example Volume 26, issue 3, Septembre 2007
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- Key words: heparin-induced thrombocytopenia, danaparoid, good use
- DOI : 10.1684/jpc.2007.0065
- Page(s) : 166-73
- Published in: 2007
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.