Conclusion:
This study illustrates that inappropriate combined antithrombotic
therapy is observed frequently among hospitalized patients, which could
result in an altered benefit-risk ratio for these patients. Optimal and
safe antithrombotic use can be stimulated by implementing an
antithrombotic stewardship that evaluates patients using combined
antithrombotic therapy, prevents overuse of the combined therapy by
adequate documentation of duration of therapy when combined therapy is
initiated and a structured validation of the indication for the combined
antithrombotic therapy when patients are already using combined
antithrombotic therapy.
Future studies are needed to conclude whether these interventions will
lead to a decrease of patients entering the hospital with a major
bleeding using combined antithrombotic therapy without increasing the
number of thromboembolic events among these patients.