eVTE: A Cluster, Randomized, Step-Wedge Study of an Alert for Extended Duration Thromboprophylaxis in At-Risk Hospital Discharge Patients to Prevent Venous Thromboembolism

What this Trial Is About

Researchers are evaluating an alert system designed to help doctors identify hospital patients at high risk for blood clots but low risk for bleeding. This study aims to see if this alert increases the prescription of rivaroxaban, a blood thinner, to prevent venous thromboembolism after discharge. The study also monitors the impact of the alert on patient outcomes such as blood clots, stroke, heart attack, death, and major bleeding. The study compares two periods: a baseline phase with no alert to clinicians and an intervention phase where a pop-up alert appears during patient discharge if certain risk criteria are met. This alert informs the clinician that the patient may benefit from extended duration thromboprophylaxis with rivaroxaban 10 mg daily for 30 days. Hospitals are introduced to the alert in groups over time in a randomized sequence. Participants include medical patients being discharged who meet specific risk criteria for clotting and bleeding. Researchers will track prescription rates of rivaroxaban from discharge to 7 days after, and clinical outcomes up to 90 days after enrollment. Safety outcomes such as major bleeding will be monitored for 30 days post-enrollment. The study runs until September 2025 and measures both how the alert affects prescribing behavior and patient health outcomes.

Alerting Providers at Patient Hospital Discharge to Consider Prescribing Rivaroxaban to Reduce Venous Thromboembolism