Transforming value-based deep vein thrombosis care through a pharmacist-led clinic.

PURPOSE: To address gaps in deep vein thrombosis (DVT) care, our health system implemented a pharmacist-led DVT clinic to standardize treatment, provide immediate access to pharmacy and vascular surgery services, and reduce emergency department (ED) and inpatient utilization for DVT management.

METHODS

This was a retrospective, pre-post cohort study of a DVT clinic that centralized imaging, diagnosis, anticoagulant initiation, and pharmacy services into a single outpatient location. Patients diagnosed with a DVT between January 1, 2023, and December 31, 2024, were included. The co-primary outcomes were the proportion of systemwide DVT encounters occurring in the acute care setting compared before and after the DVT clinic opened (2023 vs 2024) and compared between patients seen in the clinic or not (2024 only). A χ2 test was used to analyze the co-primary outcomes, with significance defined as a P value of less than 0.05.

RESULTS

The pharmacist saw 205 patients across 363 visits in 2024. Compared to 2023 baseline data, the proportion of systemwide DVT encounters occurring in the ED in 2024 decreased from 88.6% to 53.3% (P < 0.001), while the rate of inpatient admission for DVT decreased from 25.5% to 13.9% (P < 0.001). Stratified analysis of the 2024 data demonstrated significantly lower acute care utilization for DVT among patients managed in the DVT clinic compared to those not seen, including for ED encounters (15.2% vs 91.5%; P < 0.001) and inpatient admissions (1.8% vs 26%; P < 0.001).

CONCLUSION

The pharmacist-led DVT clinic represents a transformative advancement in pharmacy practice, redefining the role of pharmacists in ambulatory care and establishing a replicable model to optimize value-based care that shifts treatment for appropriate populations from acute to outpatient management.