An audit has been carried out, in a French general hospital, studying
the use of heparins in preventive indications, to assess concordance b
etween prescriptions and thrombotic risk, before and one year after th
e diffusion of national guidelines. Platelet monitoring frequency has
also been studied. On a defined day, 550 patients were admitted, and 1
13 treated with preventive heparinotherapy (low molecular-weight hepar
in: 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 overpr
escriptions 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 c
ommunicated 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 se
nsitive therapeutic classes.