Low-molecular-weight heparin in outpatient treatment of DVT

Am Fam Physician. 1999 Feb 15;59(4):945-52.

Abstract

Patients with a diagnosis of acute deep venous thrombosis have traditionally been hospitalized and treated with unfractionated heparin followed by oral anticoagulation therapy. Several clinical trials have shown that low-molecular-weight heparin is at least as safe and effective as unfractionated heparin in the treatment of uncomplicated deep venous thrombosis. The use of low-molecular-weight heparin in an outpatient program for the management of deep venous thrombosis provides a treatment alternative to hospitalization in selected patients. Use of low-molecular-weight heparin on an outpatient basis requires coordination of care, laboratory monitoring, and patient education and participation in treatment. Overlapping the initiation of warfarin permits long-term anticoagulation. Advantages include a decreased incidence of heparin-induced thrombocytopenia and fewer episodes of bleeding complications. Future clinical trials evaluating the safety and efficacy of low-molecular-weight heparin in the treatment of complicated deep venous thrombosis will further define appropriate indications for use and strategies for outpatient management.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Ambulatory Care
  • Anticoagulants / adverse effects
  • Anticoagulants / pharmacology
  • Anticoagulants / therapeutic use*
  • Clinical Protocols
  • Heparin, Low-Molecular-Weight / adverse effects
  • Heparin, Low-Molecular-Weight / pharmacology
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Partial Thromboplastin Time
  • Patient Education as Topic
  • Patient Selection
  • Venous Thrombosis / drug therapy*

Substances

  • Anticoagulants
  • Heparin, Low-Molecular-Weight