Strengths and limitations:
To the best of our knowledge this is the first study that evaluates the
effect of antithrombotic stewardship in which a prospective daily
monitoring of all hospitalized patients on combined antithrombotic
therapy is part of daily clinical practice. Therefore, the results of
this study reflect the daily clinical practice. Additionally, agreements
were made in advance within the ASP with regard to guidelines,
responsibilities, tasks and communication and therefore we had a good
basis that resulted in a dedicated and committed ASP team. Other
strengths are the prospective study design and the follow up after
post-discharge to evaluate medication safety. However, the present study
should be viewed in the context of several limitations. Firstly, not all
the interventions were recorded by the members of the antithrombotic
stewardship. This implicated that the real number of interventions is in
fact higher than reported. Secondly, for the safety outcomes we only
relied on data in the medical record in our hospital, which can result
in an underestimation of complications. Thirdly, due to COVID-19
pandemic we had fewer admissions in the last month of the study. Lastly,
the external validity is limited due to the single-centre study design.
Despite these limitations, with our results, we showed that implementing
a multidisciplinary ASP is effective in improving antithrombotic care in
patients with combined therapy.