2.1 Study design and setting
A prospective cohort study was conducted in a large teaching hospital in
the Netherlands, Amsterdam (OLVG). Consecutive patients on combined
antithrombotic therapy who were hospitalized for any reason, were
included. Subsequently, a member of the multidisciplinary ASP
proactively evaluated the appropriateness of this combined
antithrombotic therapy by assessing proper indication according to local
hospital guideline, proper prescription and length of use. In case of
doubt, the combined antithrombotic therapy was discussed in the ASP. If
needed, an intervention was proposed to the treating physician to ensure
efficacy and safe use during and after hospitalization. The
multidisciplinary ASP consisted of an internist (vascular), a
cardiologist, a (cardiothoracic) surgeon, a hospital pharmacist, a
pharmacist technician and a nurse specialist. When needed, a surgeon
(vascular) and neurologist could were consulted by ASP.
This study protocol was approved by the local ethics committee “ Advies
Commissie Wetenschappelijk Onderzoek-Medisch Ethische Commissie
(ACWO-MEC) OLVG hospital. As ASP was implemented for improvement of
daily clinical care, no written informed consent was required for the
interventions described in this study.