Analysis of Thrombophilia Test Ordering Practices at King Fahad Hospital of the University

Abstract

Abstract BACKGROUND: Thrombophilia tests are widely performed but often in a nonjustified and inappropriate manner as patients are not properly selected, or test timing is not considered. This study aims to assess the current practice of thrombophilia testing at our institution by determining the indications and the testing characteristics to start an initiative toward the reduction of inappropriate testing. METHODOLOGY: This is a retrospective study of patients who have undergone thrombophilia testing at King Fahad Hospital of the University from January 1, 2019, to December 31, 2020. The data were collected from electronic medical records. RESULTS: A total of 545 patients were included (the median age was 38, 76.4% were females). Of the ordered analyzed, 36.59% were for inappropriate indications. Tests were done in the acute phase of thrombosis in 55.21% of patients. However, 18.89% of patients had thrombophilia tests requested during anticoagulants therapy. Positive results were found in 32.66% of patients and were confirmed in 52.24% of patients. The positive diagnostic yield of thrombophilia testing at our institution was only 14.6%. Of the screened tests that required confirmation for definitive diagnosis, 52.23% was obtained. CONCLUSION: This study highlights the improper practice of thrombophilia testing, which calls for initiatives toward reduction in test request by means of educational intervention, posttest guidance by the laboratory, or restraining ordering to the highly specialized clinicians.