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Home blood clot treatment has lower risk, improves care

None of the patients in a study had recurring clots during treatment, which cost less than half of the current standard.

By Stephen Feller

INDIANAPOLIS, July 16 (UPI) -- Rather than admitting patients with potentially fatal blood clots to the hospital for an injectible treatment and observation, researchers gave patients a drug in pill form and sent them home -- which they found was more effective and included fewer risks for other issues.

The standard way to treat deep vein thrombosis and pulmonary embolism is an injection of the drug heparin and an oral drug warfarin, and then close monitoring of the patient. Both drugs require close monitoring of the dosages because of the potential for additional clots or bleeding, and warfarin requires patients to monitor their diet.

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"This study is about giving patients a new option," Dr. Jeffrey Kline, a professor of emergency medicine and cellular and integrative physiology at the Indiana University School of Medicine, said in a press release. "Treating patients at home for blood clots was found to have fewer errors than the standard of care and better outcomes. Patients have to be taught to give themselves injections, and it scares them to death. Almost everyone has taken a pill, so there is no learning curve for patients."

In a study examining the effectiveness of the treatment, published in Academic Emergency Medicine, researchers treated 106 low-risk patients that had been diagnosed with deep vein thrombosis or pulmonary embolism with rivaroxaban, which does not require blood monitoring, and then sent home. None of the patients in the study had a recurrence of clots or extra bleeding, although three of the participants had recurring deep vein thrombosis after the treatment was stopped.

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The researchers published a companion study comparing the costs of the two treatments, finding that rivaroxaban cost about half what hospitalization and treatment with heparin and warfarin costs. Of the 97 cases evaluated six months after the treatment study, the median cost for rivaroxaban was $4,787, compared with the hospitalized group with had a median cost of $11,128 per patient.

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