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8/16/2000

Guidelines for Treating Clots at Home

Cheryl A. Thompson

Home treatment of deep vein thrombosis has become more manageable, thanks to guidelines and other documents developed by home care physicians with the assistance of pharmacists.

Aimed primarily at physicians who want to move patients from hospital to home, the documents organize the outpatient treatment of deep vein thrombosis with low-molecular-weight heparin, specifically enoxaparin, and warfarin for seven days. Aventis Pharmaceuticals, maker of enoxaparin, supported the project. 

The package assembled by the American Academy of Home Care Physicians (AAHCP) contains a diagnostic checklist, inclusion and contraindication checklist, and treatment protocol. Also included are a patient consent form, checklist covering patient or caregiver counseling points, and answers to frequently asked questions. 

Although the patient consent form and counseling checklist call for discussion of potential drug interactions and dietary considerations, none of the AAHCP material states which drugs and food to avoid. 

At a minimum, the pharmacist member of the home care team should consult the package inserts for enoxaparin and warfarin and check the patient's medication list for drugs that may interact with either anticoagulant. Patient information specific to the self-administration of enoxaparin and warfarin can be found at Safemedication.com, sponsored by ASHP.